Oral Answers to Questions

HOME DEPARTMENT

The Secretary of State was asked—

Bogus Traders

Andrew Robathan: How many arrests have been made for (a) fraud and (b) intimidation by bogus traders in the last 12 months.

Hazel Blears: There is no specific offence of fraud or intimidation by bogus traders. However, the latest figures for fraud and forgery in 2002–03 show that 38,600 people were arrested, and 284,000 people were arrested for violence against the person.

Andrew Robathan: Is the Minister aware that people are particularly concerned about bogus traders who, for instance, offer to pave a drive, do a couple of hours' work and charge substantial sums—often of £5,000 or £6,000? Does she agree that that is in fact a form of criminal activity and has nothing to do with trading? People are making a criminal living out of bogus trading. Will she speak to her hon. Friend the Minister for Employment Relations, Competition and Consumers at the Department of Trade and Industry, who has said that the Government will introduce legislation to tackle such bogus trading, which currently allows criminals to prey on the most elderly and vulnerable people in our country?

Hazel Blears: The hon. Gentleman is clearly aware of the extensive work that is being carried out by my colleagues in the DTI in response to the work of the Office of Fair Trading, which was itself a response to a super complaint by the National Association of Citizens Advice Bureaux. The OFT has set out a position paper that includes a number of options, ranging from creating a new offence of fraud—also recommended by the Law Commission—and a new offence of fraudulent trading to creating a criminal offence in the circumstances that the hon. Gentleman set out. I can certainly undertake that I and Ministers from the DTI will seriously consider those propositions. Clearly, we will need to consult stakeholders, but I assure him that not only are our officials in dialogue, but we intend to have inter-ministerial dialogue as well.

David Cairns: Is my hon. Friend aware that among the worst offenders in this regard are those sales agents who go door to door, hoodwinking elderly and vulnerable people into changing their gas and electricity supply, based on an entirely bogus assessment of the benefits? Will she consider supporting my private Member's Bill, which would tighten the regulations and allow compensation for those, very often elderly, people who have been hoodwinked in that manner?

Hazel Blears: I am, of course, very aware of the elderly and vulnerable people who have been taken advantage of in those circumstances. That is why I am delighted not only that my hon. Friend is promoting his Bill, but that many of the respectable energy companies now have schemes whereby callers have not only to prove their identity, but to show householders a telephone number that they can ring to confirm the caller's identity. Such schemes are excellent, and I want to promote them.

Asylum Seekers

Teddy Taylor: How many persons in the UK are awaiting decisions on asylum applications; and what the average waiting time was for such decisions in the last 12 months.

Beverley Hughes: At the end of December 2003, the number of asylum applications awaiting an initial decision had fallen to 24,500—the lowest level for a decade. Of those applications, 7,100 were normal work in progress cases, where the application had been outstanding for six months or less. We are determined to reduce the number of applications outstanding to normal work in progress levels and, at current intake and output levels, we expect to do so during the course of this year.
	The average time between application and initial decision was 10 months for initial decisions made in 2003, reflecting the fact that we are now working through proportionately more of the longer-standing cases, but that still compares favourably with the average of 20 months in April 1997. Some 80 per cent. of asylum applications received in the period April to September 2003 had initial decisions reached and served within two months.

Teddy Taylor: I thank the Minister for that detailed reply, but is she aware of the concern about the time taken to remove asylum seekers after all their appeals have been rejected? Can she give us any assurance that progress is being made in that direction?

Beverley Hughes: I thank the hon. Gentleman for his question because he is right to say that removing people at the end of the process is not only important in its own right, but deters people from coming in and making unfounded applications. We saw that with the non-suspensive appeals process, which involved a dramatic reduction in intake as a result of being able to remove people very quickly. Removals are up this year at 17,000—an increase of 23 per cent. on the previous year—but we need to do more. We need to unlock some of the existing barriers, particularly around redocumentation and preventing people from delaying the final stage of the process with successive appeals. I hope that he will be able to persuade some of his Opposition colleagues to support the measures that we have included in the Asylum and Immigration (Treatment of Claimants, etc.) Bill because they are essential if we are to do what he rightly suggests, which is to remove those barriers and remove more people.

Gwyn Prosser: Is it not the case that the pressure on decision making will reduce as the number of new applicants reduces? Is my right hon. Friend aware that the number of new applicants coming through Dover, for instance, and the south-east has reduced by two thirds or more in the past 12 months, to the extent that the asylum estate has reduced significantly just in the past month, but is she also aware that section 55 still causes some problems on the margin? Will she look again at that problem?

Beverley Hughes: I am pleased that my hon. Friend has seen the impact in Dover of the measures that we have successfully taken to reduce the number of unfounded claims. The monthly reduction in intake is now getting on for 60 per cent. That allows us to use the resources that previously had to be invested on large numbers of initial claims on taking decisions on long-standing claims and on dealing with other elements of the system.
	I am aware of my hon. Friend's concern about section 55. He will know that, towards the end of last year, the Home Secretary announced a new approach to the section. As a result, the number of grants of support is increasing. However, it is also important that Members accept that we have to take a reasonably tough stance when we think that people are coming here and claiming asylum when they are not genuine refugees and that one of the reasons behind that is that they can be supported through the process.

David Cameron: Can the Minister tell us whether the BRACE procedures for clearing backlogs were applied to any areas other than people setting up businesses from the accession countries? If so, was the House of Commons informed on each and every occasion?

Beverley Hughes: I made it clear in my statement of 12 March that I have asked the investigating officer to widen his investigation to include any existing arrangements for clearing backlogs and any previous arrangements going back 10 years. The hon. Gentleman may wish to look at some of the arrangements that took place under the previous Conservative Government before he decides how he will respond to the findings of this report.

James Purnell: Did my right hon. Friend really say that the average waiting time has fallen from 20 months to two months—a 10-times reduction? Can she tell me who the Home Secretary was in April 1997, and does she agree that everyone on both sides of the House who now supports fighting racist parties and the British National party should put the asylum debate in context and present a balanced case based on the evidence and information rather than scare stories and gimmicks?

Beverley Hughes: In reporting the average time now, I could not give total credence to the progress that we have made. In fact, last year when we were concentrating on newer cases, the average time was six months. It has gone up to 10 months this year because, as I said, we can now invest more resources in going through the longer-standing cases. Therefore, the average has risen temporarily. However, my hon. Friend is right. In April 1997, the number of outstanding cases was 54,500 compared with 24,500 now, and the average waiting time was 20 months, which is getting on for two years, for an initial decision. The Home Secretary at that time was the leader of the Conservative party, the right hon. and learned Member for Folkestone and Hythe (Mr. Howard).
	Leaving aside the debate about such issues, my hon. Friend is right in his broader point. Unless we are able both within and between our parties to have a sensible debate about migration and unless political parties and politicians do not use this issue as a covert screen for racism and fuelling people's fear about foreign nationals, we will not be able to identify properly for people the enormous benefits that migrants bring to our economy and the social fabric of this society.

Humfrey Malins: Last week, Lord Falconer was forced to admit that, after seven years of this Labour Government, the average time lapse between a Home Office initial decision on asylum and an appeal hearing before an adjudicator is 17 weeks. Who is to blame for that extraordinary delay? Is it not one more example of this Government's sheer inefficiency in managing the asylum system?

Beverley Hughes: Although we want to go further, that 17 weeks has come down considerably from the time that it took under the Conservative Administration. In fact, we have put a great deal more resources into appeals. We can now send 3,500 asylum appeals, 3,000 entry clearance appeals and 600 non-asylum appeals to the adjudicators every single month. That is not only bringing down the number of outstanding cases that the adjudicators need to consider, but bringing down the waiting time, month on month. We will get to the point at which the whole process will take six months or less from the initial claim to the final outcome. That will happen if the Conservative party supports the Government in their efforts to reduce abuse of the appeal system and the way in which people can go back time after time after time to frustrate their removal.

Amphetamines

John Mann: When his Department last recommended that the Advisory Council on the Misuse of Drugs consider the reclassification of amphetamines; and what plans he has to do so again.

Caroline Flint: The Advisory Council on the Misuse of Drugs last reviewed the classification of amphetamines in 1995 when it agreed that class B was still the most appropriate class. There are no plans to request the ACMD to consider the classification of amphetamines, although it keeps the classification of all drugs under constant review.

John Mann: Since 1995, we have had a tenfold increase in the volume of police raids involving amphetamines. Australia and New Zealand have found in that time span that amphetamines have become their largest single drug problem. As the drug can be made in the back of a van—it is a home-produced synthetic drug—is it not time that we upgraded it to a class A drug in exactly the same way as Australia and New Zealand have had to do in the past few years?

Caroline Flint: There are different types of amphetamines: there is amphetamine, which is a class B drug, and methyl-amphetamine, which is also a class B drug. Methyl-amphetamine is especially a problem in the USA, the far east, Australia and New Zealand. Indeed, its use among the Maori tribes has led the New Zealand Government to consider reclassifying it as a class A drug. Estimates from the British crime survey for 2002–03 show that amphetamine use in the 16 to 59 age group has reduced by 50 per cent. since 1996. Of course we have to consider all drugs, but we also have to look at the families of drugs and at how they operate. I think that my hon. Friend is referring to methyl-amphetamine rather than amphetamine itself.

Linda Gilroy: I am sure that my hon. Friend agrees that although the classification of drugs and the messages that we get across about them are important, there are nevertheless many other things that we need to do to convey effectively the fact that drug abuse is bad not only for individuals, but for our communities. Will she say something about the Department's priorities for clamping down on drug abuse?

Caroline Flint: My hon. Friend is right. It is about extending knowledge and information about the different harms of drugs and how they affect our communities. I am pleased that the powers in the Anti-social Behaviour Act 2003 to shut down crack houses—houses for the use and supply of class A drugs—are already beginning to take hold, and I commend that action to police forces throughout the country, working with local authorities. If a crack house takes root, it can have a devastating impact. We must consider the matter alongside better police enforcement and better use of intelligence to crack down on middle markets. With the serious organised crime agency, I hope that we will tackle the problem nationally and internationally even better than we are doing already.

Internal Security

David Heath: What assessment he has made of the implications of events in Madrid for security arrangements in London and other major British cities.

David Blunkett: We have been on a heightened state of alert for some considerable time and remain so. A month ago, I confirmed that there was a substantial increase of 50 per cent. in the surveillance capacity of the Security Service. Last Friday, I announced £15 million extra for the special branch, £12 million of which is going into the counter-terrorism surveillance unit of the Met police. Last Friday, I attended the meeting of Justice and Home Affairs Ministers in Brussels and pressed hard for action rather than simply words and for genuine co-operation on the key areas with which we have been dealing domestically. I say to all those who are pronouncing publicly that, although it is understandable that people are raising issues that have been raised previously in the aftermath of the tragedy in Madrid—we all send our condolences personally and through our political parties to all those affected—it is absolutely crucial that people recognise that security and intelligence capacity and the work of special branch have not changed following the incident a week last Thursday. Although people are extremely worried, they need to know that every possible step is being taken to secure the interests of the United Kingdom.

David Heath: I recognise the difficult job that the Home Secretary has to do, but he must be aware of people's concerns when they hear, for example, the head of the local government emergency planners saying that we are "very, very badly prepared" for a Madrid-scale attack. The head of the Fire Brigades Union says:
	"As of now, we are not a lot better than we were on September 11th 2001".
	The chief constable of the British Transport police says that the infrastructure of his force is "crumbling" due to a lack of funding. If those on whom we rely for our defence are not confident that they have the resources or officers required to do the job effectively, how can the public have that confidence?

David Blunkett: On the British Transport police, the hon. Gentleman will be aware that that it is funded through the operators. It behoves not simply the Government, but all those engaged in maintaining the economic, social, political and humanitarian life of this country, to make a contribution. A substantial amount of the £330 million expansion in civil contingencies that we announced a year ago has been spent on things not affected by the particular society that the individual concerned chaired.
	I understand the aggravation. Despite the 35 per cent. increase in the civil contingencies grant in 2001, it has been agreed and announced—although the Emergency Planning Society does not agree with this—that it would be integrated into the normal local government grant system. There is an ongoing conflict, but it should not hide the fact that £56 million extra has been put into the fire service, £85 million has already been spent by the NHS, and there has been a massive expansion in the training of police, fire and ambulance men, all of which has been spelt out to the House at least three times by me in statements over the past year. In addition, the massive expansion in the capacity of those who can use training suits and the exercises that we have undertaken, including the one last September, have all been designed to ensure that robust resilience is in place. I repeat, however, that it is not resilience in picking up the pieces after an attack that will save this country, but the security and intelligence to prevent an attack from occurring.

David Winnick: While recognising the importance of trying to protect all our people from international terrorism and that my right hon. Friend is doing precisely that, does he nevertheless accept that compulsory identity cards in Spain in no way stopped the terrible slaughter there? In view of some of the press reports that appeared yesterday and today, would he not be over-hasty in trying to bring the cards to this country? I do not believe that they are a deterrent to terrorism.

David Blunkett: I am familiar with my hon. Friend's views on the subject. A question on identity cards has been tabled and, with your permission, Mr. Speaker, I shall answer further questions then. Suffice it to say that the system that we have in process is nothing like the Spanish ID card. I have spelt out to the House that I would not recommend a system on the European model. It is not based on biometrics and does not have a clean database, so it cannot prevent people from having multiple identities. The security services are clear—anyone who has watched television or read the papers over the past few days will be familiar with what has been said—that multiple identity is the stock in trade of international terrorism. Terrorists use it effectively and we have to take steps to stop them.

David Davis: We should recognise that credit is due to MI5, MI6 and the police on their success so far in preventing and deterring the threat that we have faced from al-Qaeda in the past decade. Nevertheless, the comments of the Home Secretary, the Prime Minister, the head of MI5 and Sir John Stevens, the head of the Met, have led people to believe that an attack is inevitable in this country at some point. That makes the comments of Patrick Cunningham that the hon. Member for Somerton and Frome (Mr. Heath) raised very important. Mr. Cunningham was not just talking about resources. He went on to say that Britain was gripped by "a culture of complacency", and that local authority planners, who are supposed to play a vital role in the aftermath of disaster, are unlikely to be able to
	"offer anything other than a token gesture of support".
	He is the leader 500 emergency planners. Are they all completely wrong?

David Blunkett: No, they are not all completely wrong, but I put out a challenge to the emergency planning officers and those who purport to speak on their behalf. If an emergency planning officer believes that something is inadequate, that he does not have the resources, that his local authority, which employs him in this case, is not doing its job and that the new regional structures that we have put in place and invested in, with back-up from the Ministry of Defence, are inadequate, why not do something about it? What is the point in being an emergency planning officer if one is not doing the job at local level? If those officers do not have the resources, they can raise the issue.
	Has any Member of the House been approached by their local emergency planning officer? Has any of those officers written to me? Has any of them written to the Minister for the Cabinet Office, who is responsible for civil contingencies, or to the Minister for Local and Regional Government? How many of those officers have raised their concerns? We know of those concerns because we read them in the papers yesterday, we saw those people on the television and we heard them on the radio, and we will happily take them seriously when they propose their own plan and suggestions for improvement. That is what is called a civil society linking up with a political society, so that not everything is the responsibility of those sitting in Westminster.

David Davis: With the greatest respect to the right hon. Gentleman, he is the Home Secretary and has overall responsibility for this area. He has to pay attention to those people. They are, after all, the people in the front line who will carry out his work in the event of a disaster. However, it is not only the people in the front line who are critical of what he is doing. Britain's emergency preparations have been criticised by the Defence Committee, the National Audit Office and the Prime Minister's strategy unit, as well as the Emergency Planning Society. Are they all wrong too, or should they all do things for themselves as well?

David Blunkett: No, all of them have made sensible, practical suggestions that we have taken on board. That includes suggestions made by members of the joint Home Affairs and Defence Committee, which I attended just two weeks ago. Those proceedings are on the record; they lasted two hours—that is called democracy.
	When people have sensible, practical suggestions, we will implement them, but I repeat what the chairman of the Conservative party, the hon. Member for Woodspring (Dr. Fox), said last night on Radio 4 when asked where the resources are to come from: we will have to take them from some other area. That is the balance that we have to strike—judging how much money in the NHS goes towards emergency planning rather than towards normal treatment. The same is equally true of local government resources and of the allocation of resources from my own budget. Paying for training, decontamination, protective suits and the exercises that we have undertaken, as well as for the fire and ambulance services, which I have already mentioned, has to be put together with maintaining the basic service, which is, after all, the lifeblood that we are trying to protect.

Dennis Skinner: Will my right hon. Friend confirm that money has been allocated for an extra 100 British Transport police on the London underground? Will he also confirm, as he has done previously, that there are now more police in Britain than there were even in 1984 during the miners' strike, when the police were supplemented by the Army? Is he aware that there is no such thing as a perfect society in which we can control all those forces that are acting against the interests of the population? If there was a way to combat the suicide bombers and all the rest, my guess is that the answer would have been found in Israel, where they have suffered such problems for many years. The truth is that an answer is not on offer, but it makes an easy shot for the Tories, the Liberals, the media and the BBC, which is riddled with Gilligans.

David Blunkett: I think that I will pass on the last point. Yes, British Transport police have been allocated on the underground as my hon. Friend described. Yes, there are 11,000 more police, compared with a drop of 1,100 that we inherited in 1997, and they are available to do the job.
	Let me make it clear that there are two separate issues here. One is the resources allocated to security and intelligence and to protecting us from attack in the first place. I do not think that anyone can dispute that we have done the job there, and I welcome what the shadow Home Secretary said about MI5, which is doing a first-rate job, as is the counter-terrorism branch. The separate issue is how we deal with an incident when it occurs, and I just say to everybody that this is not new. There are Members on both sides of the House who remember the 30 years before the Good Friday agreement, when incidents took place. There have been civil incidents such as the terrible tragedy in 1989 at the Hillsborough football ground. I remember attending the hospital where all those who were injured and the 95 who died had been taken. We are familiar with dealing with both civil and military contingencies—we have dealt with them for years. We are stepping up that aspect of resilience, so that we will be even better at it should a tragedy occur, but our primary task is to prevent it from happening in the first place.

Stephen Lawrence Inquiry

Oona King: What progress the Government have made in implementing the recommendations of the Lawrence inquiry; and what further steps are being taken to promote race equality.

Fiona Mactaggart: The Stephen Lawrence inquiry report was published on 24 February 1999 and made 70 recommendations. I am pleased to say that the vast majority of the recommendations have now been either completely or partially implemented. I have commissioned research by the London School of Economics to evaluate the overall impact of the recommendations on the police. That report is due in the summer. Following recommendation 11 of the Macpherson report, the Race Relations (Amendment) Act 2000 introduced a duty on specified public authorities to promote equality of opportunity and good relations between persons of different racial groups.

Oona King: I thank my hon. Friend for her reply. Does she agree that promoting community cohesion is one of the most important aspects of her Department's work? I hope that she is aware of the progress that Tower Hamlets has made and the national recognition that it has received for that. Will she argue for more resources to be devoted to community cohesion and promoting race equality? The issue affects all of us—as many white constituents come to see me following race attacks as black and Asian constituents. Although ethnic minorities face specific problems of institutionalised racism, which the Lawrence inquiry examined, I hope that the Government recognise that Britain must invest in promoting race equality for all the citizens of this country.

Fiona Mactaggart: My hon. Friend is right to draw the House's attention to the fact that delivering race equality and community cohesion is good for every citizen of this country, whether white or black. It is important that we all recognise that. She is also right to draw our attention to the excellent work on community cohesion being done in her constituency. Our ambition is to embed the lessons learned from the pathfinders on community cohesion in the mainstream operations of central and local government, because only by making that a normal part of doing business will we build genuinely cohesive communities throughout our country.

Mark Oaten: While I support the need for the police to challenge suspicious behaviour, especially if it involves terrorism, will the Minister explain why there is no ethnic monitoring of stop-and-search operations conducted under Terrorism Act 2000 powers? Does she accept that that goes against the recommendations of the Macpherson report and is at odds with good community relations, which are especially important if we are to fight terrorism and gain intelligence from members of such groups?

Fiona Mactaggart: People who are stopped under anti-terrorism powers are not stopped because of their ethnicity but because there is a specific need for the investigating officer to ensure that we are safe and protected from terrorism. We are introducing into general stop-and-search procedures much more robust monitoring and connecting whether the initial stop leads to a justifying outcome. It is important to have that information, so that we can determine whether the disparity in our current stop-and-search arrangements is justified, or whether we must take robust action to end that disparity.

John Wilkinson: Is it not the case that in many inner-London boroughs, a proactive, intelligence-led approach by the police is crucial to tackling endemic crime such as street crime and drug dealing? Without stop-and-search powers, would not the police be seriously handicapped in their work, to the severe detriment of Londoners in those areas?

Fiona Mactaggart: The answer to the hon. Gentleman is, of course, yes. We need to ensure that stop-and-search powers are intelligence-led and produce effective results. Intelligence-led use of the powers has disrupted gun crime, for example, but we need evidence to ensure that stop-and-search powers are being used sensibly to reduce crime. Stop-and-search is an important tool when well used, but we need to ensure that it is always well used.

Reoffending Rates

David Rendel: How he intends that the national offender management service will achieve lower rates of reconviction.

Paul Goggins: Reducing reoffending is the central objective of the national offender management service.
	This will be achieved through more effective management of offenders as well as better targeting and co-ordination of custodial and community sentences.

David Rendel: The Department's figures show that 55 per cent. of those who are imprisoned are reconvicted within two years, whereas only 45 per cent. of those who are given community sentences are reconvicted within the same period. If the national offender management service is to be evidence-based, should we not be giving preference wherever possible to community service sentences, particularly for non-violent offenders?

Paul Goggins: The thrust of the reforms under the NOMS system is to rebalance our correctional services so that those in prison are those who need and deserve to be there and from whom we need protection. Those who are non-dangerous and commit less serious offences should be dealt with effectively in the community. The reoffending rates of those who complete sentences in the community are encouraging. It is an important message that effective work and tough sentences can be carried out in the community where that is appropriate for particular offenders.

Keith Bradley: Will my hon. Friend tell the House when the national rehabilitation action plan will be published? When it is published, will it include the key recommendation of the social exclusion unit report on reducing reoffending—a going straight contract?

Paul Goggins: I cannot confirm the contents or the precise date of the national rehabilitation action plan. However, I can confirm that work continues apace to draw up that plan. In the Prison Service, much greater emphasis is being placed on housing advice, advice from Jobcentre Plus staff and advice on drug treatment and education. All those ingredients need to be joined together much more effectively with what happens in the community after release from prison. That will be the focus of the national rehabilitation action plan.

Andrew Selous: Does the Minister accept that reconviction rates would be lower if the recommendations of the Carter report were agreed to, which would see prisoners placed in prisons nearer to their families?

Paul Goggins: One of the considerations of the Prison Service when allocating prisoners to prisons is closeness to home. It is somewhat regrettable that a third of all prisoners are more than 50 miles away from home. However, other considerations have to be taken into account. It is essential that contact is maintained with families throughout the prison sentence, and we do everything we can to encourage visits by families to prisoners, but the pressures on our prisons sometimes make it unavoidable that prisoners are further away from home than would ideally be the case.

Prison Overcrowding

Annette Brooke: What action he is taking to tackle prison overcrowding.

Paul Goggins: We are taking immediate action to increase the number of prison places, with an extra 2,500 places to be available by the end of 2004.
	We will continue to press sentencers to use community sentences rather than short-term prison sentences for non-dangerous, less serious offenders.

Annette Brooke: The Minister will be aware that the Home Office projection suggests that it is highly likely that the prison population will reach 80,000 this year. Furthermore, the Carter report recommended that the population of those in custody should be stabilised at about 80,000. Does the Minister accept that recommendation? Will he set clear targets that will address slowing down and reversing the trend of an ever-increasing prison population?

Paul Goggins: Patrick Carter predicted in his report that if we did nothing to rebalance the correctional services, the prison population would be about 93,000 by the end of the decade. With the reforms that he recommended, it is possible to maintain a stable prison population at about 80,000, and that is what we intend to do. In the short term, we shall certainly make available the additional prison places that I mentioned in my initial reply—about 2,500 by the end of the year. It is important that the message goes out to sentencers that wherever possible community penalties should be used instead.
	In his report, Patrick Carter emphasised the increasing severity of sentences. Someone is five times more likely now to be given a custodial sentence for shoplifting than was the case 10 years ago. That is hardly justifiable. Community sentences should be used wherever appropriate.

Vera Baird: My hon. Friend may be aware that the Fawcett commission on women and the criminal justice system, in which I have been involved, is about to report. One of its findings is that two thirds of women in prison, who are contributing to the overcrowding problem, are there for dishonesty. Does he agree that society pays a price if people are put into prison unnecessarily, as the result may be family break-up, home break-up and loss of jobs? Is it not time to evolve the principle that carers, whether male or female, ought to be the last people to be put in prison, and that that principle should start to emerge in sentencing policy, unless, of course, those people are dangerous and violent?

Paul Goggins: As my hon. and learned Friend will recognise, the nature of the offence is crucial when sentence is passed, but she is quite right to point to the additional dimension for women who are put in custody—namely, their child care responsibilities. She will know that just over a week ago I published the women's offending reduction programme, which highlighted various actions that we are taking, such as improving bail information systems in prisons for women and improving mental health care for women offenders outside prison. I am also looking closely at our use of bail hostels to make sure that we are making maximum use of them as an alternative to prison. The issue of women in prison is high on my agenda, and I intend to continue pressing forward and making sure that wherever possible low-risk women offenders who have not committed particularly serious offences are dealt with outside prison.

Cheryl Gillan: The Minister is incredibly complacent when he says that a couple of thousand prison places are coming on-stream at the end of the year, because we need prison places now. The operational capacity of our prisons has dropped this week from 75,191 to 75,073, so he has just eight places left before the system is completely and dangerously full. Does he agree with the general secretary of the Prisoner Governors Association, who said this morning that the Prison Service is now taking more chances with the prisoners that they are sending out of the system? What assurances can he give us that, despite the crisis that he has created, he will not permit the premature release of unsuitable prisoners?

Paul Goggins: I assure the House that I am not complacent about my responsibilities—nor do I hide away from the pressures. May I correct the hon. Lady's figure on the operational capacity of our prisons, which today stands at 75,291? It is important to put on record an accurate picture.
	We have provided 14,700 additional prison places since 1997. Before the end of this year, we will add a further 2,500. We are not complacent, and will not release people into the community if there is a risk. However, if they are low-risk offenders and if it is appropriate to deal with them in court via a community sentence, that is what sentencers should be doing.

Rob Marris: May I point out to my hon. Friend that one effect of overcrowding is an increased rate of recidivism? Young people in particular in the secure estate do not get the education that they deserve in prison, and have disproportionately high rates of illiteracy. That problem is not addressed properly in prison. Will my hon. Friend explain to the House why spending per capita in 2002 on education in the secure estate was only two thirds of the equivalent figure in secondary schools, when those are some of the most vulnerable people?

Paul Goggins: We continue to increase investment in education in our prisons. In the current year, we expect 50,000 basic skills qualifications to be gained in our prisons. If we are to tackle recidivism and create the opportunity for people to stay free from crime, it is essential that they are better educated and have a better chance of gaining employment. I assure my hon. Friend and the House that I regard that as a high priority.

Police Finance

David Amess: What meetings he has held with representatives of police authorities regarding the proposed 2004–05 funding settlement.

Hazel Blears: I met police authority representatives or Members of Parliament from six force areas during the consultation period about next year's settlement. Full account was also taken of 63 written representations covering 32 police authority areas, including those from Essex Members of Parliament. The funding settlement was finalised on 5 February.

David Amess: May I note that there seems to be a peculiar noise in the Chamber, Mr. Speaker?
	Is the Minister aware that the Association of Chief Police Officers has calculated that following the Home Office settlement, there is a funding shortfall of £250 million? In the debate in Westminster Hall last week, I shared with her my concern about police in Southend being stretched. With reference to Essex in particular, other than high council tax increases and cutting police numbers, can she think of any other way of addressing the serious shortfall in funding?

Hazel Blears: The hon. Gentleman mentions that we had a useful debate in Westminster Hall last week. I promised to reflect on what he said, provided that he got things into perspective. I said to him that Essex had had a very generous settlement this time in comparison with other forces. If we had applied the formula, Essex would have received £15 million less than it did. Because we had a flat-rate settlement of 3.25 per cent. for every force, it received an extra £15 million. It has also had 149 extra police officers since 1997, and an extra 483 police staff and 91 community support officers to patrol local areas. The increase in the county's precept was the second lowest in the country, and it was an extra 12p a week for excellent policing services in Essex.

Ann Cryer: Is my hon. Friend aware that when she meets representatives of police authorities, she will receive a positive response from West Yorkshire police authority? With Mr. Speaker's permission, I shall quote a letter from Councillor Mark Burns-Williamson, chair of West Yorkshire police authority, who said:
	"You will be pleased to learn that the Home Office is making an additional special grant of £1 million to the Police Authority in respect of the Bradford riots of July 2001.
	I have written to . . . the Minister of State . . . expressing our appreciation for this support from the Home Office."

Hazel Blears: I am grateful to my hon. Friend for highlighting the appreciation of her police force for the action taken by the Home Office. I am sure she knows that over the past three years there has been a 30 per cent. increase in funding for the police service—a 17 per cent. increase in real terms. That is a tremendous record of investment in the police service, because we know how much it is valued by local communities such as my hon. Friend's. Right across the country, policing is crucial to building safer communities on which our people depend.

Mr. Speaker: Order. There seems to be a faulty air conditioning unit, which is causing excessive noise. Will the Officers of the House see that it is turned off?

Bob Spink: I am grateful to the Minister for her detailed response on funding for the police in Essex. Is she aware that one of the results of the lack of funding for police in Essex is that the Rochford and Castle Point division of that constabulary is currently running at 27.7 per cent. below police establishment, which is causing enormous problems of street disorder and crime? What does she intend to do to make sure that she gets the Castle Point and Rochford division back up to its full establishment on the street?

Hazel Blears: Despite the noise, we still get a lot of hot air in the Chamber, Mr. Speaker.
	I know that the hon. Gentleman has a question later on the Order Paper, so I took the trouble to make inquiries of his police service this morning. I can tell him that he has a special operation there consisting of a sergeant and 10 extra officers dedicated to tackling antisocial behaviour. They are doing a tremendous amount of work in his local area to tackle the problems of youth nuisance, intimidation and harassment, and I am sure he will be glad to have that extra force in his constituency.

Hugh Bayley: What proposals he has to improve the accountability of police authorities in England for the council tax precepts they impose.

David Blunkett: Follow that from my hon. Friend the Minister of State.
	My hon. Friend the Member for City of York (Hugh Bayley) knows that the decision rests with the police authority, but in our consultation paper, "Policing: Building Safer Communities Together", which we published on 4 November, we challenged everyone to come forward with ideas about improving accountability at neighbourhood level, at command unit level and for police forces as a whole, taking into account both the nature and the make-up of those forces.

Hugh Bayley: The police precept in North Yorkshire has more than doubled in the past three years, but not all the extra money is being spent on front-line policing, which is what the public want. Although we now have the largest ever number of police officers in North Yorkshire, people in the central area, which includes the city of York and suffers from half the crime in the county, have less than half the police resources. People would like to see a police authority that represents their views and ensures that resources are placed where they are most needed in the county.

David Blunkett: I understand that minority political representation is not available from the city, and I think that that is a great shame, as the strength of any reform of the police service will be to maintain the consistency and continuity that come from drawing together people of good intent, whatever their politics, to form a consensus behind political priorities and investment. I hope that the North Yorkshire force will take note of my hon. Friend's plea and recognise that, where there have been additional strains in North Yorkshire, such as in the policing of Menwith Hill, the Home Office has been prepared to put in extra resources to ensure that policing is not damaged, including in places such as York.

Andrew Mitchell: The Home Secretary will be aware that it has been extremely difficult to reach a settlement this year in the west midlands, where there has been a 12.5 per cent. precept and the force has had to dip into reserves to the tune of £5 million. Does he accept that, unless he looks carefully at the arrangement for next year, it will not be possible to reach a settlement in the west midlands without either a massive increase in the precept or a diminution in the police service?

David Blunkett: There has been a particular challenge for major urban and metropolitan forces, not least because, after massive representations, we agreed to a flat-rate increase in the police grant. [Interruption.] [Hon. Members: "Bravo."] Bravo indeed. Obviously, there have been very substantial additions to the police grant in the west midlands through the crime fighting fund, Airwave and other activities, but I accept entirely the cry from the west midlands, which has a good police force that has done a great deal of imaginative work and made a substantial difference to policing at a local level.

Bill O'Brien: Does my right hon. Friend accept that it is important that the police should be accountable to people who are paying the police precept? One way of doing that is through the community police forums. In West Yorkshire, the police authority is reducing the number of police forums. I consider that a move in the wrong direction in terms of trying to secure police accountability. Does he accept that there has to be more accountability and not less, as there appears to be in West Yorkshire?

David Blunkett: Following the consultation, we will produce a further document with more positive proposals on which we will consult in relation to accountability, responsiveness and availability at local level. We believe not only that it is good that the police themselves should be accountable at each level of the service, but that engaging the public is a very positive way of ensuring that they can reduce crime. In areas where such positive engagement has occurred, there is a material difference in terms of collaboration with the community, the preparedness of witnesses to come forward and the success of the police in reducing not only antisocial behaviour, but the volume of crime.

James Paice: The Home Secretary and his police Minister claim credit for all sorts of achievements—they recite figures about extra police officers in every constituency—yet at the same time, they criticise the police authorities for raising their precepts by considerably more than the amount of extra money that they received from the Home Office. Now the Home Secretary is talking about the principle of accountability. Is he talking about the accountability of the same police authorities that have to submit their annual policing plan to him, after which he has the power to send it back, a bit like a child's homework, over and over again until they get it right? Are these the same police authorities whose control over expenditure has shrunk over the years as their budgets have been held back while centrally determined ring-fenced budgets have increased by anything up to 50 per cent. a year, as has happened in some cases? How can he really talk about increasing accountability if he is not going to give the authorities some responsibility for what actually goes on in their area so that they can take the credit or, if necessary, the blame? Will he tell us what powers he is going to give back to police authorities?

David Blunkett: I was not aware that I had taken any powers away from police authorities. The hon. Gentleman did not list a single responsibility that I have taken away from police authorities or any changes that I have made to their ability to hold chief constables to account. Police authorities often grumble that they are not responsible for holding the police chief and his senior officers to account, and the hon. Gentleman cannot have it one way but not the other.
	I shall quickly deal with the individual issues. First, we have not held down precepts. Secondly, we have not criticised police authorities about precepts—the final precepts have not even been announced yet, so even if we wanted to criticise police authorities, we could not do so. Thirdly, we have been working with police forces. Fourthly, I did not claim credit for what has happened in the west midlands or north or west Yorkshire; I commended West Midlands police on its actions and said that police on the ground working with local people made the difference. We have made a difference by putting resources in. Yes, the ring-fenced crime fighting fund has led to an additional 11,000 police officers, 3,500 community support officers and 10,000 extra civilian staff compared with the loss of 1,100 police, no community support officers and no proposals for investment in civilianisation that occurred in the years leading up to 1997, which is precisely why the Conservative party lost.

Peter Pike: My right hon. Friend knows that I welcome the Government's improvements to policing in this country since 1997. However, a blueprint for policing in Lancashire was published last October, and this year the precept has increased by 15 per cent., which will not meet the demands and expectations of Lancashire police. Lancashire police believed that with a Labour Government it would get better policing, which it could not get under a Tory Government.

David Blunkett: I agree entirely with my hon. Friend. I am pleased by the way in which the chair of Lancashire police authority has led the reform agenda and made changes at a local level, including measures to increase social cohesion, which is so important in my hon. Friend's constituency.

Immigration and Nationality Directorate

Angela Watkinson: If he will make a statement on the relaxation of clearance standards in the immigration and nationality directorate.

Beverley Hughes: The hon. Lady is aware that an investigation is under way and a further statement will be made as soon as possible after it has been completed.

Angela Watkinson: Will the Minister comment on the accuracy of newspaper reports last week that, in dealing with a backlog of 29,000 citizenship applications, caseworkers were instructed to accept what people told them about their absences from this country and to dispense with checks on travel documents and passports? If so, is she concerned that there may be one person among those 29,000 people whose reasons for absence from this country may be more sinister than the explanation that they have given?

Beverley Hughes: We must all accept, that, under any Government, past or present, most Departments must take sensible measures to deal with backlogs. The important point is that those decisions must be based on a clear assessment of risk, proper research and clear information. The change to citizenship procedure is entirely different from the issue that occurred in Sheffield and is the kind of sensible measure that any Department would take. Staff suggested the change, which was risk assessed. They examined what people had written on their applications about holidays and business trips taken abroad in 100 randomly selected cases and found that in all those cases that information could be reconciled with those people's passports. It was clear that it was entirely safe to take at face value what was written on the application forms for that particular group of applications. That decision did not affect character checks, police crime checks, national security checks—where appropriate—or the examination of the full immigration history on all those cases. The measure is sensible and proportionate, and it is right to support it.

Vincent Cable: Following the revelations that the whistleblower from the immigration and nationality directorate was a political activist who had openly advocated the use of nuclear weapons against Muslim radicals, what steps is the Minister taking to ensure that in future her Department conforms to the standards of impartiality that one would expect of the civil service?

Beverley Hughes: The hon. Gentleman makes a valid point. No matter how rigorous one's recruitment and selection procedures, when one is appointing large numbers of people, it is possible that people who have not declared particular points of view or allegiances will sometimes get through. I understand that Conservative Members in particular will want to exploit the issue, but it is regrettable that the leader of the Conservative party aligned himself very publicly with this individual without making the necessary checks as to whether he was a worthy person. It was no surprise when he had rapidly to distance himself the following day.

Deployment of British Forces (Kosovo)

Tam Dalyell: (Urgent Question): To ask the Secretary of State for Defence if he will make a statement on the deployment of British forces in Kosovo.

Adam Ingram: Last week, there was an upsurge in violence in Kosovo that resulted in deaths in the ethnic Albanian and Serb communities, as well as hundreds injured, including some KFOR troops. Although Kosovo is now calmer, the potential for renewed violence remains. The troops who were already in Kosovo were heavily committed in dealing with the situation. Commander KFOR therefore took the decision to authorise the deployment of his in-theatre tactical reserves to assist with the situation. In addition, NATO issued instructions to reinforce KFOR with additional SFOR troops from Bosnia, including a UK company of 1st Royal Gurkha Rifles, a US company and a company from the Italian multinational support unit, the carabinieri.
	In the early hours of Thursday 18 March, NATO called forward the operational reserve force ready battalion. The ready battalion role is one for which the UK has responsibility during the first six months of this year. The lead elements of the operational reserve force ready battalion—approximately 150 men—left RAF Brize Norton on Thursday afternoon and landed in Kosovo late that evening. The vast majority of the operational reserve force ready battalion of around 660 men has now deployed, with the 1st Battalion the Royal Gloucestershire Berkshire and Wiltshire Regiment providing the core of the battalion group. Around 1,100 UK armed forces personnel are now deployed in Kosovo.
	The purpose of the deployment is to restore calm to the province and to prevent unrest spreading to areas outside Kosovo—the type of task for which the operational reserve was designed. UK troops will, as tasked by Commander KFOR, conduct routine patrolling, the guarding of sites such as the UN mission, and public order duties. To call upon the in-theatre tactical reserve, followed by the operational reserve, then the strategic reserve, is the correct, graduated and planned response to such a situation. The fact that Kosovo has been calmer over the weekend shows that that was the correct decision.
	Further to the deployment of the UK battalion, NATO has requested that an element of the NATO strategic reserve force, provided by a French battalion, should also be deployed to Kosovo. NATO has also requested the deployment of the three standby battalions that make up the full operational reserve force. Those battalions are provided by the US, Germany and Italy. The German battalion will, in the first instance, be deployed to Skopje, Macedonia. It is for NATO to determine for how long reserves will be required, but in terms of an initial estimate, and with the situation changing, we believe that a sensible course of action is to plan initially for a deployment period of about 30 days. The situation in Kosovo now appears calmer, although it is still tense.
	With permission, Mr. Speaker, I should also inform the House that we have received preliminary reports of an incident involving British troops in Basra this morning. Right hon. and hon. Members will understand that the information remains incomplete. Initial reports indicate that two explosions took place. We have reports of injury to 13 British soldiers, although none is believed to be life-threatening. The process of informing next of kin is under way. It would be inappropriate to make any further comment at this stage.

Tam Dalyell: I accept that it would be inappropriate to say anything about events in Basra.
	As one who was the guest for four days during their deployment in Kosovo of my national service regiment, the Scots Dragoon Guards, may I ask the Minister to say something about the horrendous difficulty of the task that faces NATO troops, who are often the proverbial piggy-in-the-middle in the searing bitterness between Serb and Albanian? What can be done to prevent the ethnic cleansing of the Serbs? We do not have to give in—do we?—to the aspirations of those who want a Greater Albania.
	My right hon. Friend referred to the holy sites. What can be done about the burning of the churches, which are genuinely important to European heritage? Is it sensible to talk in terms of imposing a corridor to the unique monastery at Gracanica, which is so important to Serbs anywhere in the world? What can be done to protect the nickel factory, which is the engine of Kosovo production, and help it to recover from the American bombing? Those who have been there know its importance in generating any sort of meaningful employment. It is a genuinely urgent matter.

Adam Ingram: I am grateful to my hon. Friend for recognising the difficulty of the task. Any peacekeeping mission has attendant risks and Kosovo clearly ranks high in that. That is why the decision was made to deploy at short notice.
	My hon. Friend asked about the future for Kosovo. Of course, that is matter for the discussions, which are at a very early stage. The Foreign and Commonwealth Office takes a lead in that and it is working on the best way to deal with the continuing process of trying to establish a stable set of relationships in the Balkans.
	On sensitive sites and their protection, it is a matter for the commander of KFOR to make the best use of his troops; the judgment call rests with him. However, from my experience and that of my hon. Friend, there is an awareness of the sensitivity of specific sites and the way in which any attacks on them, whether people are present or not, can impact on the environment.
	My hon. Friend made a point about the economy, although he particularised it by mentioning one factory. Kosovo's economy is in difficulties—I believe that unemployment is around 70 per cent.—but economic stability can be developed only on the back of a secure environment. They must go hand in hand. The more we can stabilise security, the greater the prospects for economic rejuvenation and regeneration in Kosovo.

Nicholas Soames: I thank the Minister for bringing us the anxious news from Basra. I am sure that he will keep the House informed as matters develop.
	Nobody should be under any illusions that we are considering the most serious crisis in the Balkans since the end of the Kosovo war. Last week's violence between the Kosovo Serb minority and the dominant ethnic Albanians was surprisingly swift and widespread. There is no doubt that it represents a major setback for the Kosovo peace process and the international community's efforts in the province. It was probably inflamed by extremists of what used to be the Kosovo Liberation Army. The importance of the quick and robust deployment should not be underestimated.
	The stakes are high. The destabilisation of Kosovo would result in further and more serious bloodshed in the province and further instability in south-eastern Europe. We cannot afford that. The work done and the progress achieved must not be undermined. Will the Minister confirm that the NATO Secretary-General is visiting the province?
	Will the Minister answer the following questions? I understand that 1st Battalion the Royal Gloucestershire, Berkshire and Wiltshire Regiment is providing the core of the operational reserve force battalion group. What is the length of that commitment likely to be? Who will replace the RGBW as the core spearhead battalion? Will he confirm that the deployed troops have been issued with a full complement of personal equipment, including enhanced combat body armour?
	According to the Serbia and Montenegro army chief of the general staff's interpretation of the Kumanovo agreement between NATO and the then Federal Republic of Yugoslavia in 1999, the Serbia and Montenegro army could be allowed to return to Kosovo in exceptional circumstances. Can the Minister clarify whether that is really the case? Under what circumstances will that be allowed to happen?
	What representations did NATO receive from the Serbia and Montenegro Defence Minister in Belgrade? How many NATO troops have been sent from Bosnia to Kosovo? Is the Minister confident that the security situation in Bosnia is stable enough to allow this temporary reduction in troop numbers? Furthermore, and importantly, what is his assessment of the effect that that will have on the EU takeover of the NATO SFOR operation in Bosnia and Herzegovina?
	We are entirely confident that British troops will play a full and, as always, distinguished part in getting Kosovo back to normality. We wish them every success and a safe and prompt return.

Adam Ingram: In response to the hon. Gentleman's first point, of course I will keep the House informed of developments regarding the incident in Basra, and I hope that the information that I gave—that the injuries do not appear to be life-threatening—remains correct.
	The hon. Gentleman is right that this is a significant issue. He is familiar, because of his time doing my job and his time in Northern Ireland, with the fact that any peace process in relation to major conflict between ethnic groups has the capacity to spill over. That must be planned for at all times. The rapid deployment of these reserve forces is a good indication of that knowledge being immediately to the fore of all planning considerations, so that we could deploy back to the area if required.
	The hon. Gentleman asked about the length of time of the deployment. I stated earlier that 30 days is what is anticipated, but that will be dependent on NATO's request. In relation to the lead battalion, the UK was designated for the first six months of 2004, to be followed by the US, so we are halfway through that six-month period. The initial commitment, however, is anticipated to be for 30 days. If the situation can be stabilised, we can withdraw, and if there is a need for extension, of course, that judgment will have to be made following NATO's request. In relation to who then fills that lead role, 1 Para will step into that readiness role.
	The hon. Gentleman asked about a full complement of equipment. I can tell him that the troops deployed have been given a full complement of equipment. He also asked about the deployment of Serbian forces. I know of no plans for that to happen. It seems to me that there would have to be a mature set of relationships between Kosovo and Serbia for such a development at this stage. As to the deployment of troops from Bosnia, as I indicated in my opening statement, three companies were moved initially from Bosnia, and the reserve, to be followed by the strategic reserve, will make up the numbers that the NATO commander requires.

Alice Mahon: May I put it to the Minister that in 1999, 200,000 Serbs, Roma, Gorani and other ethnic groups either left out of fear or were driven out by the KLA—almost certainly the same people who organised a very effective burning and looting of 3,500 homes, churches and so on in the last few days? The UN spokesman has confirmed that. Has the Minister or the Prime Minister any plans to visit some of the people who have been ethnically cleansed for five years now, and who are living in miserable conditions in camps in Serbia and Montenegro? Will he do something about ensuring that they return safely and are protected? We hear reports that French troops and the police stood by while houses and churches were burned. Surely, if he supported the action to drive the Serbs out of Kosovo, as he did, it cannot be the case that one set of ethnic cleansing is right and the other is wrong.

Adam Ingram: I do not think that NATO, the European Union, the United Nations or, indeed, the United Kingdom Government would say that one form of ethnic cleansing is wrong and another is right. Our aim in deploying troops into this troubled region is to bring back peace, separate the warring factions—if that is how they should be described—and find a way of establishing stability, so that we can make progress on the other agenda.
	My hon. Friend is right: there are many tragic stories to be told about the Balkans. I think that we as a nation can hold our head high in view of the way in which we have contributed to the effort to find a solution. Many thought we should not engage in the Balkans, as they think we should not engage in other trouble spots; but if we have to face up to harsh realities and deal with big issues, it will mean a commitment of British troops.
	Of course we shall do all we can to ensure that those who have been displaced across the region have a calm, peaceful future, but that will take time. It cannot simply be asked for. It must be delivered on the back of what we do in this country, through Europe and through the United Nations, and we must also build on any good will that may reside within these troubled communities.

Tom Brake: I, too, thank the Minister for agreeing to keep the House informed about the incident in Basra.
	We entirely agree with what the Secretary of State said in his written statement about the need not to lose the gains made in Kosovo so far, and the need for our forces to bring stability to Kosovo and make it clear that ethnic cleansing is unacceptable. Can the Minister tell us what impact, if any, there will be on any existing UK commitments or responsibilities if the operational reserve force has to stay for more than 30 days, and what additional UK reserves are available for deployment if additional forces are required to bring stability to Kosovo?
	It is early days for the ORF, but has any preliminary assessment been made of whether it is likely to have to stay beyond the 30 days, or whether it might be able to return before they have elapsed? What will be the impact if it is required to stay beyond June 2004?

Adam Ingram: There will be no impact on other UK commitments. The ready battalion was designed specifically as an over-the-horizon force. As I explained in response to an earlier question, when it moves out others will move in to replace that capability. Plans have been made to cover predicted eventualities, although no one can say what else may be on the horizon. We must plan for such things, in one sense, but we must also stand ready for what may be unexpected. I cannot give answers about the future, because I do not have the capacity to predict with any certainty what else may happen internationally. What I do know is that the British armed forces have shown time and again that when there is a requirement for them to deliver they will do so, in a very professional and committed way.
	The reserve force represents a multinational rather than just a UK response. A good many nations are very committed: there are some 42 in the Balkans, 25 of them European. We must show that international resolve and international strength can be used to deal with the emerging problems—quickly, we hope. Although the situation is calmer now, there is still tension. We have specified 30 days initially, but if the troops are required to stay longer and if the NATO commander wants them to do so, that is what they have been designated for. The questions must be answered at the time, however, because we do not know quite what the demand will be so far into the future.

David Winnick: To keep the matter in perspective, is it not the case that the NATO intervention five years ago stopped state organised ethnic cleansing and massacres, some of which were reported to the House, which led to the House concluding that such an intervention was absolutely necessary? Have not allied troops done a very good job in the past five years in trying to keep the two hostile communities apart, until the very sad situation last week? By and large, has not the intervention of 1999 shown itself to be absolutely justified?

Adam Ingram: I agree with my hon. Friend. I visited Kosovo in 1999 to look at the police presence. At that time, I was the Minister responsible for security in Northern Ireland. We put in a sizeable contingent of officers from the Royal Ulster Constabulary, as it was called then. Together with other police, they made a major contribution alongside the military in Kosovo. There is no question that what we did then was correct. Although some had doubts about it then and may still have doubts about it now, it was correct. Our recent deployment shows the strength of our resolve to try to work this through to a positive conclusion.

Hugh Robertson: I associate myself entirely with the expression of good wishes to our armed forces as they deploy, but is not the lesson elsewhere in the Balkans, particularly in Bosnia, that enclaves on their own, such as we saw in Jepa, Srebrenica and Gorazde, are not viable in the longer term? What impact will that have for the long-term future of Kosovo?

Adam Ingram: In a sense, that is going into territory for which I do not have direct responsibility. Trying to manage the process and to get people reintegrated to stop enclaves of people, as they can be described, clearly has big attendant risks but, as I said earlier, the process must develop with the good will of the people. It cannot be an imposed solution, so we have to marry up those two very difficult, conflicting problems. Some ethnic concentrations can put other minority ethnic concentrations at risk. That must be taken into account in seeking to establish any long-term structure for the Balkans, Kosovo and Serbia and for the various ethnic groupings in those areas. However, I do not think that what we are doing now is about trying to resolve the specific problem that the hon. Gentleman raised.

Hugh Bayley: When I visited Kosovo with the NATO Parliamentary Assembly, I was encouraged to see the progress that was being made in the Kosovo police service and at the Kosovo police training college to bring in people from all ethnic groups to train them together and to ensure they slept in the same dormitories, attended classes together and learned each other's languages. Does my right hon. Friend agree that it is important to continue to provide resources that bring the communities together for training on issues such as policing, and that there is a general lesson that after conflict we have to continue to invest in post-conflict reconstruction if we are to provide a viable future for a country emerging from civil war?

Adam Ingram: I agree entirely with my hon. Friend. It is important to continue all our efforts. The eight standards that have been set—and that will be subject to review in the middle of next year to see what progress has been made—take into account the normalisation of that society, for which the overall security profile becomes important in terms of civil administration, policing and the judiciary. At present those are proving difficult, but that is what we must all strive towards. Important steps have been made. We have achieved some measure of progress, but there is a long way still to go in all this. My hon. Friend is right that, in terms of post-conflict reconstruction, we need to be there for a considerable period because, again, as the old phrase goes, peace is not an event but a process. It will take time—both in the initial phase that we are now in and in later stages—to get it right.

Andrew MacKay: As someone who strongly supports the deployment, may I gently put it to the Minister that it was unfortunate, to say the least, that it was the Father of the House, through an urgent question, who brought a Minister to the Dispatch Box? In future, when there is a major deployment, can we guarantee that the Secretary of State or, if he is absent, the Minister, comes to the Dispatch Box? That is what the House needs and deserves.

Adam Ingram: In terms of the timing, the call was made in the early hours of Thursday morning, as I explained, and it is a normal deployment; it is what that force stands ready for. The judgment was made, and we would have thought that the House understood that, as it was a normal deployment—[Interruption.] Clearly, some Members do not think so, which is why the Father of the House, my hon. Friend the Member for Linlithgow (Mr. Dalyell), requested an urgent question and was granted one. Clearly, we will take lessons from that if lessons need to be taken. We will take such things into consideration in any future deployment, but should this apply to withdrawals as well? Should justification be given for every decision? [Interruption.] Well, I am only posing the question because I am sure that some would think that they always have the right to ask such questions. If a withdrawal took place, they would ask about the basis of the withdrawal. The right hon. Gentleman says that the deployment is significant. It involves a battalion that stood ready for the purpose, and I explained the reasoning behind that in my opening statement.

John Wilkinson: As a company of Gurkhas from the stabilisation force in Bosnia and Herzegovina, next door, was promptly on the scene, will the Minister respond to the pertinent question asked by my hon. Friend the Member for Mid-Sussex (Mr. Soames) from the Front Bench? Will such an intervention by a reserve—a back-up—from the stabilisation force in Bosnia and Herzegovina always be available from that country once the stabilisation role is taken over by the European Union? NATO is responsible for that now, so there is inherently no problem—but, if the forces are under EU control, there could be a fatal interval before a deployment takes place.

Adam Ingram: Those are the very issues that must be bottomed out in considering the future presence in Bosnia. We have not reached a final conclusion, but NATO is comfortable with the development of those talks. We are quite far down the road of working out what the force package should be in Bosnia and how it should be structured and utilised. The hon. Gentleman will be aware that we consider the Balkans as, in a sense, one region because each country impacts on the other, and the force strength there should be best utilised to deal with the problems as they arise. Sometimes that will be straightforward; sometimes it will be difficult, depending on the circumstances. That is why we need such a significant international commitment to the force; it cannot be delivered by the UK and the US alone. We need many allies to participate. Of course, the Italians, the French and the Germans are heavily committed, along with other European nations, to deliver the very mission that we are seeking to deal with at present.

Crispin Blunt: The Minister should be aware that when the Defence Committee visited our troops in Kosovo last month, a clear majority of them did not think that a deployment in Kosovo was a worthwhile use of their time. The Government have been warned repeatedly that the political strategy that NATO is following, which our troops are being asked to support, would end in their being attacked by the very people whom they went there ostensibly to help. As the Serbian Government, who after all hold the sovereignty of Kosovo, now appear to be talking about the partition of various parts of Kosovo, I urge the Minister to get hold of the Foreign Office and get it to support any strategy that will bring political closure to the issue and enable us to get our soldiers and the rest of the international community out of Kosovo, there having been a political settlement.

Adam Ingram: I will not respond to the hon. Gentleman's first comments, where he seeks to speak for all the British forces in Kosovo, as though he is some great guru of knowledge because of a visit there. He suggests that the troops have one clear, focused view of their deployment. I hear what he says, but there is no point in entering into that territory.
	I indicated in an earlier answer that the Foreign and Commonwealth Office is, of course, very active in trying to work through solutions and in considering how the process can be moved forward. That is not easy. Competing, conflicting ethnic demands are involved. It is big scale and cannot be resolved at the flick of a switch. It is not a case of the FCO putting in another set of resources, thus resolving the situation. It has to be worked through with the international community and with the countries and ethnic groupings in that area. As I indicated, the eight strands of development are subject to review in the middle of next year, and I understand that the FCO has three teams working on developing the best way forward. The Government are committed to finding a solution, and I should have hoped that the hon. Gentleman would support us in that.

Michael Weir: The Minister said that the UK troops were the ready battalion for the first six months of this year. Do I take it that he anticipates a reduction in the number of British troops at the end of that six-month period should the situation in Kosovo continue to be fluid? If not, is he satisfied that, given the commitments in other parts of the world, he has sufficient reserves to rotate troops out of the trouble spots?

Adam Ingram: I am conscious that the leader of the hon. Gentleman's party said that it was an unpardonable folly to get involved in Kosovo in the first place, so I do not know whether the hon. Gentleman is now supporting what we are seeking to do in Kosovo and understands that the scale of what we seek to achieve is important not just for the people of that region but for Europe and beyond. I explained that the lead battalion stands ready for a six-month period and that we were given that task for the first six months of this year and were to be followed by the United States. We alternate on that basis.
	Our commitment as lead battalion will be for six months, and that period will end in the middle of this year. The current deployment is initially for 30 days, but that will depend on circumstances on the ground and the request then made by the commander of KFOR. As I said in an earlier answer, I cannot predict far into the future. We have to deal with each situation as it arises and we have clearly been able to deliver when we have been called upon. However, I am conscious of the fact that the hon. Gentleman and his party have opposed probably every important international mission that we have sought to get engaged in. I do know what their motivation is in all that.

John Randall: Does the Minister agree with the assessment of many people, including the spokesmen for United Nations Mission in Kosovo—UNMIK—and for NATO, that the violence was not spontaneous but was, in fact, co-ordinated? Does that have any implications for our troops?

Adam Ingram: We do not yet have a mature understanding of what precipitated the violence, but the best information that I have is that it looked as though it was spontaneous and was built on the back of a particular grievance, but that it then became organised. That would not be unsurprising, but it does not mean that it is necessarily the case. Extremists can exploit any point of unrest and they are very quick to move in to maximise the potential for what they seek to achieve. We therefore have to get the best information on the ground and, importantly, to analyse it to make sure that we make the best response.

Bob Russell: Can the Minister confirm that the British Army is between 3,000 and 4,000 soldiers under strength. With that in mind and given all the existing commitments, does he agree that overstretch is getting worse and that the additional commitments now being imposed on the Army are adding to the stresses and strains? Although he mentioned the European nations that have supported peacekeeping in Kosovo, does he agree that more effort should be made to encourage greater European support for what the British Army is doing?
	The Minister will also be aware that 500 troops from Colchester garrison are serving in southern Iraq. Will he please keep me posted on the desperate situation reported in Basra today?

Adam Ingram: I gave the information that the hon. Gentleman referred to in his final point, but I hope that he realises why I gave it. It is breaking news and I thought it important to impart it. I have given the best information that we have and I shall, of course, keep the House informed as the situation develops.
	The hon. Gentleman asked about the strength of the British Army. We have had the best recruiting year for the past 20 years. There are now 2,000 more in the Army than there were at this time last year. That is a significant achievement. He will be aware that we are continuing to move towards full manning strength, although it takes a lot of effort by, and commitment from, those in the training regime and the recruitment environment. We have worked hard to eat into the under-strength that exists, and we are making some progress.
	On greater European support, the involvement of 25 European nations indicates a measure of commitment, although clearly it is of varying degrees. Given the type of initiatives that have taken place in the EU, there is no question of trying to make the Balkans an EU-led issue, and I would expect the hon. Gentleman to support that. The approach must be consistent with what we have been able to achieve through NATO and we must be able to match NATO's capabilities. I shall keep him up to speed with what is happening in Basra and Iraq at present.

David Cameron: Clearly, anything that happens in Kosovo has important knock-on effects next door in Macedonia. Does the right hon. Gentleman agree that it would be highly desirable to give that small country as many reassurances as possible before making a statement about the future status of Kosovo itself? Does he agree that those reassurances should include encouragement about future NATO and EU membership, and perhaps even calling the country by its proper name rather than a bizarre set of initials?

Adam Ingram: We are some way away from the final status for Kosovo. As I have indicated, we are only in the foothills of several of the developments that have taken place there. I also pointed out in my earlier answers that there is a need to ensure that every party is taken along with the process. It would be wrong to develop and impose an answer that would create greater ethnic conflict. Having said that, I do not have the capacity to say at this stage that that will be delivered any more easily than the hon. Gentleman could deliver a profile for the future of the region. There is a lot of work to be done and the presence of our troops is required to maintain stability there. We shall do what we have to do to bring about the peaceful future that I know he wants not only for Macedonia, but for the rest of the Balkans.

Points of Order

Oliver Heald: On a point of order, Mr. Speaker, of which I have given you notice. You will know that I tabled an urgent question this morning about the serious incident here on Saturday, when demonstrators were able to climb St. Stephen's Tower. I have voluntarily withdrawn it because I recognise the difficulties in examining detailed security matters on the Floor of the House. However, would you agree that it was highly irresponsible of the people involved to take such action and that it was worrying that the response was so slow? Last week, I wrote to you setting out in confidence a range of issues on how to protect the Palace of Westminster. Can you assure the House that all aspects of security, including those set out in my letter, are now under the fullest possible review, and that even if security measures cause inconvenience to hon. Members and their staff, they will be fully considered with action taken as appropriate? What assurances are you able to give to the House, Mr. Speaker?

Several hon. Members: rose—

Mr. Speaker: Let me reply to the hon. Gentleman.
	I do not intend to discuss the details of our security measures on the Floor of the House, but I assure the House that I take the incident at the weekend extremely seriously. I have received a full report from the Head of Security and have inspected the area where the breach took place. An urgent review is being undertaken, both of the security precautions in that particular area and of our security arrangements as a whole. The House should be aware that any significant tightening of security in this building is likely to give rise to some inconvenience for Members, staff and visitors. I look to Members to set a good example in this respect and not to make the job of our security staff any more difficult than it already is.

Eric Forth: Further to that point of order, Mr. Speaker. We are most reassured that you are taking a close interest in this matter, but can you assure us that those who are responsible for advising you and, indeed, for the security of the building and the premises generally are taking an equally serious view of the matter? You cannot be expected to supervise the process personally, so I hope that we can have your reassurance that they are taking it seriously and that you have had their reassurances that everything will be done to ensure that the situation cannot be repeated.

Mr. Speaker: When I heard of the situation on Saturday, I was, of course, in my constituency in Glasgow. I told the senior Officers of the House responsible for security to be at a meeting this morning, and told them not to meet in my study but to get their overcoats on because we were going outside to see exactly where the breach of security took place. Every senior Officer is well aware of the fact that I want better security in this building. I reiterate that that will mean inconvenience for hon. Members. If they are taking guests on to the Terrace and are stopped by security staff, I do not expect them to give any security officer who is acting under my instructions any difficulty whatever. I say that because that has happened time and time again in this House of ours.

Andrew MacKay: Further to that point of order, Mr. Speaker. I very much welcome what you just said and your personal involvement in the security case. Will you confirm that the very people who failed to secure the House properly and allowed the breach of security to take place are the same people who are advising you and the House—in my view, quite wrongly—that we should have a security screen in the Public Gallery?

Mr. Speaker: Let me preface my remarks by saying that I do not wish to go into serious detail about security matters on the Floor of the House. My predecessors always felt strongly about that, and so do I.

Peter Lilley: On a point of order, Mr. Speaker. You will know that it is almost unprecedented for a Minister to disclaim responsibility for the policies pursued by his or her Department. In those circumstances, it behoves the whole House to seize every opportunity to hold that Minister to account. There seemed every possibility that we would have an opportunity to question a Home Office Minister on the apparent lack of control on the crucial issue of immigration, which concerns all our constituents, when we reached question 10, tabled by my hon. Friend the Member for Upminster (Angela Watkinson). Yet you will have observed, Mr. Speaker, that because of an organised attempt at filibustering, with long and unhelpful answers to previous questions, we only just got to question 10 at the end of Question Time. The Minister concerned then gave what was, in effect, a statement rather than an ordinary answer, thereby depriving us of the opportunity of holding her to account for her denial of responsibility for the policies pursued by her Department. Can you make it clear to Ministers that an irresponsible Minister is worth as much as a three-pound note?

Mr. Speaker: I will not be drawn into that matter.

Cheryl Gillan: On a point of order, Mr. Speaker. Our prisons are full to bursting, in crisis and only a small number of places away from being at full operational capacity. At Home Office questions, I asked the Minister about operational capacity and said that the number of people in prison was 75,073—only eight places away from being full. The Minister replied that that was incorrect. I left the Chamber and checked the statistics for the Prison Service on the Home Office website. Indeed, the website confirms that the operational capacity is 75,073 and that there are only eight places left.
	Can you advise me, Mr. Speaker? Either the Minister or the official Home Office website is wrong. In dealing with such a sensitive matter, how are hon. Members supposed to get their information? Should not the Minister come to the House and apologise either for the inaccuracy of Home Office information or for his response in Question Time?

Mr. Speaker: The hon. Lady well knows that Home Office questions last an hour. It seems that she is trying to go beyond the hour. She can always seek a meeting to take up the matter directly with the Minister concerned.

BILL PRESENTED

Sovereignty of Parliament (European Communities)

Mr. William Cash, supported by Mr. Richard Shepherd, Mr. Eric Forth, Sir Nicholas Winterton, Mr. Edward Leigh, Sir Teddy Taylor, Mr. Richard Bacon, Mr. David Heathcoat-Amory, Denzil Davies, Mr. John Redwood and Sir Peter Tapsell, presented a Bill to provide that Community treaties, Community instruments and Community obligations shall only be binding in legal proceedings in the United Kingdom insofar as they do not conflict with a subsequent, expressly inconsistent, enactment of the Parliament of the United Kingdom: And the same was read the First time; and ordered to be read a Second time on Friday 14 May, and to be printed. [Bill 76].

Food Labelling

Richard Bacon: I beg to move,
	That leave be given to bring in a Bill to make further provision for relevant information about food, including information about the country of origin, contents and standards of production of that food, to be made available to consumers by labelling, marking or in other ways; and for connected purposes.
	I am pleased to invite the House to give leave for the introduction of a Bill to promote the clearer labelling of food. My proposal has support from Members on both sides of the House, and the aim is quite simple: to provide clearer, more accurate and more honest information to consumers about the food they buy than is currently required.
	There are good reasons for seeking greater clarity in the labelling of our food. The first relates to the standards of animal welfare. Consumers make buying decisions according to various criteria, including quality and value for money, and also according to knowledge about the standards of animal welfare under which livestock is reared. Consumers are rightly concerned to know that the food that they buy in the shops is produced using the best animal welfare practices. Farmers in the United Kingdom must observe some of the highest animal welfare standards in the world, and that has the wide support of consumers. Accordingly, consumers should be able to use their buying decisions to support the production of food that meets high animal welfare standards. However, British farmers who adhere to those high standards often face unfair competition from imported food that is produced to inferior standards and is thus cheaper to produce.
	The second reason for clearer labelling relates to animal disease. After the outbreaks of foot and mouth disease and classical swine fever, animal health risks have taken on a new importance in the public mind. The risks of animal disease in relation to imported food are beyond the control of individual farmers, but there is a role for the Government in ensuring that the provenance of all food is clear to consumers through clear labelling. The commission set up by the Government to review the future of farming under the chairmanship of Sir Don Curry stated that the controls that are considered necessary for food safety in this country should also be enforced on imported food. In particular, it is for the Government to ensure that there are the strictest controls, meeting the highest international standards, on illegal meat imports.
	The third reason that we need clearer food labelling is that, at present, consumers are being misled. For example, it is possible to import lambs to the UK from France, slaughter them in the UK and label the result "Product of Britain". Pork that has been imported from Denmark and then packaged in the UK may also be called "Product of Britain". Butter churned in England using milk imported from Belgium should not, supposedly, be labelled "English", but it can lawfully be described as "produced in England from milk". Norwegian salmon that has been smoked in Scotland should not, supposedly, be called "Scottish", but it can lawfully be described as "salmon smoked in Scotland". At present, producers of imported meat can lawfully use the Union flag on packaging to imply that the product is British when it is not. In addition to the Union flag, phrases such as "Great British recipes" may be used on the packaging—for example, on imported pork—again implying that the meat is British when it is imported.
	The fourth reason for clearer labelling is the position of British farmers and farming. In recent years, the farming sector in this country has seen the worst crisis for perhaps two generations. When the Curry commission was first set up by the Government to examine the future of farming, its remit included advising the Government on how to ensure that the farming and food sector contributes to a thriving and sustainable rural economy, as well as advancing environmental, economic, health and animal welfare goals. One of the key links in achieving those goals is the role of consumers, and in its final report the commission stated:
	"The key objective of public policy should be to reconnect our food and farming industry: to reconnect farming with its market and the rest of the food chain; to reconnect the food chain and the countryside; and to reconnect consumers with what they eat and how it is produced."
	At the heart of my Bill is the aim of empowering consumers. There is an intimate relationship between the buying decisions of consumers on the one hand and our continuing to have a farmed landscape that the public can enjoy on the other. However, no consumer can make a proactive decision to support domestic production without clear information.
	Consumers may wish to exercise their choice in various ways. Their choices might reflect the desire to purchase food that is produced to our standards of production and animal welfare, or, by buying local food, to reduce fossil fuel emissions by reducing the long-distance transportation of food. Consumers may wish to buy imported food from specific countries, or to avoid doing so. Whatever consumers' desires, they cannot make informed choices without accurate information at the point of sale, and that requires clear food labelling. My Bill will require clear labelling of the country of origin. If food has been processed or packaged in a country other than the country of origin, details of the country of origin will be marked on the label in no less prominent a manner than the details of where the food has been processed or packaged. Where animal welfare standards for the production of food are lower than in this country, a reference to that fact should appear on the label.
	I should make it clear that my Bill contains no proposals to restrict the legal import of foodstuffs, or in any other way to restrict competition. Such measures would be likely to infringe international trading agreements and European Union law. Under existing EU arrangements, the labelling of the country of origin is already required for fresh fruit and vegetables and, in the light of the BSE crisis, for beef. Under EU law, the so-called "promotion" of food from a particular country is not permitted, but the relevant EU directive itself requires an indication of the place of origin of a good if failure to give such an indication might mislead a purchaser to a material degree about its true origin. The clear labelling of the country of origin for all food, as my Bill proposes, offers equal treatment to all producers. In fact, it is logically impossible to suppose that providing greater transparency to consumers in a given marketplace can be said to favour one product over another. Providing more accurate information to potential buyers and sellers simply improves the operation of that market. None the less, if the happy consequence of greater transparency and more accurate information is that more consumers choose to buy food produced in Britain, I shall be very pleased, as will many farmers and food producers in this country. That is not the same as promotion, which is a matter for individuals and businesses.
	In that respect, I pay special tribute to the Budgen's supermarket group. While I was visiting the Budgen's store in Harleston in my constituency, the chief executive, Mr. Martin Hyson, explained to me the company's policy of stocking only British meat. I also pay tribute to Waitrose, which has a policy of selling only British beef, pork and chicken. Sadly, not all supermarkets follow those excellent examples. Many habitually use their near-monopoly power to screw down on suppliers in a way that I believe is against the public interest. A food manufacturer recently told me about another company he knows of that supplies major supermarkets in the UK. One division of that company had a turnover of £400 million, yet made a profit of only £150,000. In other words, for every £2,666 of turnover, the company made a profit of £1—a profit margin of just three-eightieths of 1 per cent. When it is scarcely viable to be a food producer for the major supermarkets, the temptation to cut corners grows, which may lead directly to food scares and other problems. The ruthless behaviour of many supermarkets forces suppliers to search out, at all costs, the cheapest possible source of every ingredient, almost regardless of the long-term consequences for animal welfare, the environment, food safety, and the future of British farming.
	Restraining the excessive power of the supermarkets is outside the scope of my Bill, but I believe that providing consumers with the accurate information that they need to make informed choices is a step in the right direction. There are some signs of progress. The National Pig Association promotes the quality standard mark for British pork, which is useful to consumers. The little red tractor mark, which the National Farmers Union originally developed in conjunction with the Government, is another useful measure, although it could do more. In fact, the mark does not indicate definitively that food is British produced, but shows only that the food complies with British standards. My Bill would take matters a step further. I very much hope that British consumers, armed with better information from clearer food labels, will choose to support domestic production and thereby to support higher animal welfare standards, British farmers and the sustaining of a farmed landscape in this country.
	Question put and agreed to.
	Bill ordered to be brought in by Mr. Richard Bacon, Mr. Frank Roy, Mr. Kevan Jones, Mr. Keith Simpson, Mr. A. J. Beith, Angus Robertson, Mr. Alan Williams, Alistair Burt, Mr. Stephen Pound, Ms Candy Atherton, Mr. David Ruffley and Sir Nicholas Winterton.

Food Labelling

Mr. Richard Bacon accordingly presented a Bill to make further provision for relevant information about food, including information about the country of origin, contents and standards of production of that food, to be made available to consumers by labelling, marking or in other ways; and for connected purposes: And the same was read the First time; and ordered to be read a Second time on Friday 16 July, and to be printed [Bill 77].

ROYAL ASSENT

Mr. Speaker: I have to notify the House, in accordance with the Royal Assent Act 1967, that the Queen has signified her Royal Assent to the following Act:
	Consolidated Fund Act 2004 Orders of the Day

WAYS AND MEANS

Order read for resuming adjourned debate on Question [17 March].

AMENDMENT OF THE LAW

Motion made, and Question proposed,
	(1) That it is expedient to amend the law with respect to the National Debt and the public revenue and to make further provision in connection with finance.
	(2) This Resolution does not extend to the making of any amendment with respect to value added tax so as to provide—
	(a) for zero-rating or exempting a supply, acquisition or importation;
	(b) for refunding an amount of tax;
	(c) for any relief, other than a relief that—
	(i) so far as it is applicable to goods, applies to goods of every description, and
	(ii) so far as it is applicable to services, applies to services of every description—[Mr. Gordon Brown.]
	Question again proposed.

Budget Resolutions and Economic Situation

John Reid: We on the Labour Benches are immensely proud of our national health service and of those who work in it. We say that not because NHS staff never make mistakes; they do. Any organisation that has to treat 1 million patients every 36 hours is obviously fallible. We do not express our support because the system is perfect. No human organisation that depends on the endeavours of 1.3 million people could possibly amount to perfection. However, we express support and our pride in the NHS because it brings more relief to people from pain, distress, anguish and insecurity than any other organisation in the world.
	The question that we face, as we consider the implications of the Budget, is not whether the NHS is perfect or whether some imperfections can be elicited from the 1.3 million people who are engaged in their daily and determined work. The question is threefold. First, has the performance of the NHS improved over the past six years, recovering from its two decades and more of under-investment? Secondly, is it continuing to improve, and will the recent Budget contribute towards that continuing improvement? Thirdly, what alternative policies—in particular those of the Conservative party—would underpin or undermine that improvement, which has been taking place for the benefit of the vast majority of people who depend on the NHS? That is what we must consider.
	The NHS is based on the principle of equal access to health care, free at the point of need. Its comprehensiveness and fairness is admired the world over, except occasionally, perhaps, on the Opposition Benches. It is paid for out of general taxation, and to date I have seen no convincing evidence that there is a better way of providing equity of access for an entire nation—and the beneficiary of the NHS is this whole nation.
	We are proud that the system is British in its origin, British in its originality and British in its basic principle of matching excellence with equity. The Conservative party is proposing policies that would undermine that basic principle. Let us be clear during the debate that we cannot maintain an NHS that provides equal access for all if we subsidise those who can pay to jump the queue to a position above those who cannot afford to do so. Those two aims are incompatible and contradictory. We cannot give everyone the same chance of surviving ill health if we subsidise people who can pay to jump the queue but not those who cannot. We cannot pretend to give everyone a choice if only people who can pay have that choice. Those are simple truths—[Interruption.] We will let the nation decide whether those truths are simple and clear enough, and I look forward to letting it judge support for the national health service at the election.
	The Conservative policies of diverting resources away from the many who depend on the NHS, towards the few who can afford to pay for private operations, are based on a cruel and callous deceit that is disguised as a so-called passport out of the national health service. The British people do not want a national health service in which public money subsidises queue jumping, which is why we welcome the fact that the next election will be fought on the principle of equal access to health care and why the Budget underlines that principle. [Interruption.] There appears to be a fashion for becoming ill at the podium when making a speech, but I assure the House that that is not flattery in any form.

Simon Burns: Have some water for the cough.

Alistair Burt: rose—

John Reid: I will take a drink while the hon. Member for North-East Bedfordshire (Alistair Burt) intervenes.

Alistair Burt: I thought that I would help the right hon. Gentleman by giving him a couple of minutes. It might assist him if, instead of trying to explain Conservative policies, he left that issue to my colleagues on the Front Bench. He could then use the reduced time available to address his own policies and the deficiencies of the service over which he currently presides.

John Reid: I was just trying to be helpful.
	When we came to power, we encountered a national health service that had serious capacity constraints—I do not think that any Opposition Member, however critical of the Government, would deny that—and had not received adequate investment for two decades and, indeed, some would say longer. We introduced measures across the system in Budget after Budget to increase capacity, raise quality and decrease variation of quality, which are all based on an increasing number of national service frameworks. We continue to develop those frameworks, which provide clear national standards and identify best practice so that users, managers and professionals alike have information and guidance to improve local services, for which we set a number of targets.
	Previous under-investment was chronic and disabling. We made a start in correcting that from the publication of our 10-year plan onwards, but much more was needed, which is why my right hon. Friend the Chancellor announced in his 2002 Budget historic levels of investment in the national health service. For the five years from 2003–04 to 2007–08, NHS funding in England will increase each year by an average of 7.3 per cent. in real terms—the highest increase over the longest sustained period in the history of the national health service. That investment and reform are already producing results, such as increases in capacity. We have more staff delivering health care in the NHS than ever before—over 7,300 more consultants, over 2,300 more general practitioners and over 67,500 more nurses than in 1997. That is a token of our commitment to the national health service. A vast number of people in more than 70 professions are relieving pain—day in, day out.

Kevan Jones: Does my right hon. Friend agree that striking examples of that investment in my constituency are the new hospital in Chester-le-Street, a new doctor's surgery in Craghead and a proposed new health centre in Stanley, which would be put at risk if the Opposition implemented their vision of cuts in public services?

John Reid: Yes, indeed. Later in my speech I will deal with the Opposition's plans for a massive diversion of funds away from the national health service. My hon. Friend is correct in pointing out that we have the biggest and most sustained building programme in the history of the NHS, not only in terms of hospitals, but through the refurbishment of some 3,000 general practitioners' premises throughout England.
	There have also been real increases in output: 1.7 million more patients were seen for new hospital out-patient appointments last year than in 1997, which is a 15 per cent. increase, and there were 113,000 more cataract operations than in 1997, which is a 70 per cent. increase—all ignored in the so-called productivity figures that are made up by the Opposition. There were 19,000 more knee replacement operations than in 1997, which is a 69 per cent. increase; there were 950,000 more planned hospital admissions last year than in 1997, which is a 22 per cent. increase; and of course the NHS plan target of 6,000 extra heart operations by April 2003 was achieved a year earlier.

Andrew Lansley: Given what the Secretary of State has said, how does he explain the fact that just a few weeks ago the Organisation for Economic Co-operation and Development said of the NHS:
	"Productivity seems to have declined as the growth in the number of doctors, nurses, hospital buildings and equipment have (not yet) been fully reflected in a growing number of treatments. In fact, growth in the volume of health care output has slowed down compared to the first half of the 1990s"?

John Reid: The OECD, like the hon. Gentleman, has ignored the new walk-in centres, the new treatment centres, the 6.3 million people dealt with by NHS Direct, and the 400,000 operations. All those are increases in productivity that are ignored by the Opposition, who consider one element only of NHS operations: the full-time equivalent episodes carried out by consultants in hospitals.
	Let me give an example. Of the 30 to 40 per cent. increase in investment over the past few years, a substantial amount goes in new drugs—statins. Over six years, they have contributed towards the biggest decrease in deaths from heart-related diseases in any country in the world—23.4 per cent. Statins, which account for about 10 per cent. of that decrease, have therefore led to a huge fall in mortality from circulatory diseases. The Opposition regard that as a fall in productivity; it is a fall in productivity because the people thus saved do not end up in hospital. It is a perverse definition of productivity that has been manufactured by the Conservatives purely to run down the NHS, which is their aim.
	Let me deal with some of the increases in quality and access that are also ignored by the Opposition. Nineteen out of 20 people can now see a GP within 48 hours. It was scandalously difficult to see a GP when we inherited the national health service from the Conservatives. Nine out of 10 people can now be seen, diagnosed and treated in accident and emergency departments within four hours—a world-class standard. None of those increases in quality and ease of access has been taken into account by the Opposition. They do not want to concede to the NHS any improvement, because they want to privatise health care in this country.

Linda Gilroy: May I invite my right hon. Friend to visit Plymouth, where he will see our new cardiac unit, which is now treating 1,850 people a year, compared with some 700 people in 1997? Given that heart disease has not increased by that amount in our area since that time, what does he suppose happened to the patients who were unable to get such treatment before we had the welcome investment that is pouring into the south-west?

John Reid: What my hon. Friend says is absolutely true. I will be delighted to come to Plymouth if I can arrange a visit, but I am afraid that I have so many openings of so many establishments throughout the country that it may be some time before I can do so. Some 23 NHS-run and two independent sector treatment centres have now opened; between them, they will treat an additional 50,000 patients this year. There are also 42 NHS walk-in centres; 140 million more items were prescribed last year than six years ago; and there has been a 29 per cent. increase in drugs, which is bringing benefits. All those things are ignored, of course, by the Opposition, but they are bringing substantial improvements in people's lives. Indeed, they save lives.
	I have recently given two figures. There have been sustained reductions in death rates from cancer, and a 10 per cent. fall in the rate of premature deaths—that is, among under-75s—from cancer since the 1995 to 97 figures were issued. Furthermore, death rates from heart-related disease among under-75s fell by more than 23,000 in the five years up to 2000 to 2002. That is a substantial saving of lives in this country as a result of the work of the national health service and the investment put into it.
	None of those things makes me complacent for one moment and nor do they satisfy Labour Members. We will not rest until we have restored our national health service to where it belongs: at the top of the excellence league as well as the fairness league. There is a long way to go in investment, reform, effort, leadership and endeavour. There is also a long way to go in recognising that another core value of the national health service must be better promoted. Nye Bevan's vision was not simply that the people of this country should have equity of access to medical care free at the point of delivery, although it was that. It was also that people should have access to the best medical care.
	That is why we have already started to match our investments with reforms, bringing new ideas and a better range of services to the British public, including new services such as the easily available walk-in centres that I mentioned and the fast-track treatment centres, many of which are inside the national health service. On some occasions, the independent sector treatment service is used and items are purchased in bulk at a reasonable price and delivered free at the point of need to everyone in this country. As to telephone advice, 6.3 million callers spoke to NHS Direct last year.
	All this requires the national health service continually to refresh itself by introducing the latest and best innovations, based on the latest and best available research evidence. That is why we established the National Institute for Clinical Excellence to provide patients, health professionals and the public with the authoritative guidance that they need on current best practice and health technologies and clinical management of specific conditions. That is another advance that is recognised as among the best in the world—indeed, it is the best—and it is establishing clinical excellence throughout the national health service.

Martin Smyth: I welcome the improvements and changes that are taking place in the health service, particularly in dealing with those with hearing problems and in using the independent and private sector. Is the Secretary of State aware, however, that there is some concern about whether, after new hearing aids are provided and adapted, people go back to that sector or to the national health service? Is he prepared to deal with that situation, bearing in mind the fact that people get used to those who provide the service and want the follow-up to be convenient?

John Reid: I thank the hon. Gentleman for his comments. By arranging a plurality of provision, we are giving a better degree of service and a choice. That is being introduced steadily. It is not the illusion of theoretical choice for everyone that is being offered by the Opposition, which depends on how much money one has in one's pocket.
	The increased capacity that we are introducing will genuinely extend choice for patients in the NHS. As the hon. Gentleman says, some of that choice is provided by the independent sector, and I assure him that as the years go on we do not intend to limit and narrow the choice available to patients; rather, we intend to preserve that choice and, as far we can, extend information, power and choice for patients.

Simon Burns: Does the Secretary of State remember his letter to the Health Committee on 5 February this year in which he stated that last year the national health service spent £100 million in the private sector, but that if the work had been done in the NHS it would have cost £70 million, which is a difference of £30 million? That means that the health service spent 43 per cent. more on private care in the private sector for NHS patients. Is the Secretary of State concerned, and what will he do to narrow the gap?

John Reid: The hon. Gentleman is right in every particular. Because we bought operations from the private sector at spot prices, we paid extra premiums of 50 per cent., 60 per cent. and above. He is right to point out that that disturbed me, which is precisely why we no longer do it. Now, we buy in bulk the vast majority of operations that we purchase from the private sector. For example, the most recent purchase that I concluded was for 40,000 cataract operations at the quality and price that we wanted, which was, as it happens, 10 per cent. below the tariff for the national health service. That purchase bought us another 40,000 cataract operations delivered free at the point of need, which dramatically reduced waiting times in several parts of the country for old people waiting for free cataract operations.

Simon Burns: The Secretary of State says that he thought that those premiums were wrong and that he has taken action. Does that mean that he is criticising the former Secretary of State for Health, the right hon. Member for Darlington (Mr. Milburn), who negotiated the deal?

John Reid: Not at all. As it happens, the negotiations for the cataract operations that I mentioned began under my predecessor, my right hon. Friend the Member for Darlington (Mr. Milburn). I thank him, and commend him on his foresight in heading in that direction.
	Our ambition for the national health service demands even greater foresight. All knowledge-based elements of the national health service need a constant supply of evidence from new research, especially in fast-moving fields such as medicine. We have always recognised that, and we began to deal with the most pressing needs in 2000, which is why we have invested in cancer research in particular.
	We set up the National Cancer Research Institute, which is a partnership of the 19 largest funders of cancer research in the United Kingdom, including Government, the voluntary sector, industry and patients' representatives, and the national cancer research networks followed on from that. I have no hesitation in saying that the national cancer research networks have been a huge success with both patients and practitioners of medicine in this country.

Keith Bradley: My right hon. Friend is absolutely right that the cancer research network has been a huge success, and Christie hospital in my constituency is at the forefront of that progress. The Wolfson molecular imaging centre is a world-class clinical research centre located at Christie hospital, and it currently receives a small amount of money from central Government. In the light of the Chancellor's announcement of a significant increase in the science research budget, will my right hon. Friend re-examine the funding of the molecular imaging centre at Christie hospital to see whether more central Government money can be allocated to it?

John Reid: I will not give my right hon. Friend a specific answer to that specific question, but in general terms he will not be displeased by the next 15 minutes of my speech. The national cancer research networks are a huge success, and he echoed that point. They have hit the target of doubling the number of patients engaged in trials in only two years. I make the simple point that, just as investment elsewhere saves lives and reduces pain, investment in cancer research saves, and has saved, lives for the national health service.
	We recognise the potential of the new genetics to have an impact on health care. The whole field of genetics offers the possibility of much more personalised treatments and prevention strategies. Accordingly, we invested in six genetics knowledge parks—five in England and one in Wales—to develop for us knowledge of how advances in genetics will affect the national health service. In addition, we have just finished commissioning research work on gene therapy for single gene disorders and safety studies. Investment in research on genetics saves lives for the national health service and for the people of this country.
	We are as ambitious for the British people as they are for themselves and their families. Since we know that this investment saves lives for the national health service and the country, the Government will now go further and faster in investing in clinical research. Our experience with the National Cancer Research Institute taught us that the real power to solve some of our outstanding health problems comes from the Government's investing in collaboration and in partnership. That is why my right hon. Friend the Chancellor announced last Thursday an increase in funding for medical research.
	I can report today that I am making available an additional £25 million in each of the next four years, over and above the inflation-linked increases that have already been agreed, to secure the necessary development of our medical research here in this country. That is an additional £100 million per year by 2007–08, which represents the largest sustained increase in NHS research and development funding ever announced in this House. The hon. Member for South Suffolk (Mr. Yeo) is yawning. I hope that when he rises to his feet he will give a more substantial response to my announcement.
	It is anticipated that that investment, together with the additional resources that are expected to be made available to the Medical Research Council, should allow combined Government spending on medical research to rise to £1.2 billion a year by 2007–08—investment in medical research to save lives in this country through and with the national health service.

Martin Smyth: In announcing that investment in the health service, the Secretary of State will recognise that the Northern Ireland Office has to allocate the funds. Does he agree that the new centre of excellence at the Belfast city hospital, which has international links, is making tremendous advances in research on cancer problems; and will he encourage the Chancellor to ensure that some of the extra money goes there?

John Reid: I will go half way with the hon. Gentleman. Having have seen the prowess of those at that hospital and the developments that have taken place there, I agree that they are significant and worthy of great plaudits. I cannot allocate any of the money that is disbursed in Northern Ireland, since, alas, I moved on from being in a position to do so some two years ago, but I can assure him of two things: first, that under the Barnett formula there will be significant moneys for disbursement on health in Northern Ireland; and secondly, that the Under-Secretary of State for Northern Ireland, my hon. Friend the Member for Basildon (Angela Smith), will judiciously exercise her discretion over that disbursement. I hope that that is to the benefit of the institutions that he mentions.

Linda Gilroy: If the Secretary of State can accept the invitation to Plymouth that I extended to him, he will appreciate the way in which the new Peninsula medical school is helping us to train more doctors for the health service. However, it is one of eight new medical schools that are seriously exercised by the lack of research funding. Will he give his personal consideration to the new medical schools' need for some of the research funding?

John Reid: I shall bear my hon. Friend's comments in mind. She would not expect me to make an instant allocation, although I am attracted by the prospect of a visit to her constituency.
	I reiterate that investment in research saves lives. It is not simply a matter of retaining our place at the forefront of research and development in this country—although I am proud of that, too—but of saving the lives of our fellow citizens. The Government therefore wish to make Britain the best place in the world bar none for research, development and innovation. I want to ensure that the NHS contribution to medical research is one of the centrepieces of that ambition.
	Alongside investment we shall also introduce reform. Accordingly, the Government have decided to create a new United Kingdom clinical research collaboration involving the NHS, patients, the Medical Research Council, the Wellcome Trust, the medical charities and industry. The purpose is to create a partnership to oversee the effective and efficient translation of scientific advances into patient care. I should like them to promote the following elements in particular: the development of a clinical research infrastructure embedded in the NHS; an expansion of United Kingdom clinical research, including clinical trials; an extensive and sustained increase in the research work force, and the development and spread of best practice for statutory regulations.
	We already punch above our weight in health science. The United Kingdom, with 1 per cent. of the world's population, funds 4.5 per cent. of the world's science, produces 8 per cent. of the world's scientific publications and receives 9 per cent. of the citations. Fifteen of the world's top 75 medicines were discovered and developed in Britain. It is a tradition round which this country's reputation and renown have been wreathed with laurels for decades. The Government will ensure that that continues. We shall waste no time in doing that—the inaugural meeting takes place next month.

Andrew Lansley: I share the Secretary of State's appreciation of the quality of clinical research. Many of the organisations to which he referred expressed serious reservations about the proposed structure in the Human Tissue Bill. Will he assure hon. Members that when the Bill returns to the House for Report, he will have made substantive amendments to deal with the anxieties that the Medical Research Council, the Wellcome Trust and others expressed?

John Reid: My hon. Friend the Minister of State has met representatives of those who expressed such anxieties. If she decides to make any changes, she will present them to the House. All hon. Members will have noticed the eager support of the hon. Member for South Cambridgeshire (Mr. Lansley) for the comments about our renown, reputation and investment in scientific research and development. We therefore await with bated breath the Opposition's response to our announcement of investing some £200 million extra in that research to ensure continuing quality in Britain.

Paul Burstow: In explaining the Government's approach on investment in medical research, will the Secretary of State also set out their plans to expand investment in research to preventive health care and public health? Although there is some investment, it is dramatically less than the amount that he has announced so far for medical research.

John Reid: That is the subject of considerable and extensive consultation throughout the country. The appropriate time to comment on that is when we publish the White Paper on public health at the end of the consultation.
	As I said, the inaugural meeting will be held next month, and this research will be developed in relation to a number of early priorities. Accordingly, we have been developing a United Kingdom strategy to deliver progress on drugs for use with children. This strategy will network paediatrics research centres and resources to fund the necessary clinical research. I have decided that that should go ahead as quickly as possible, not least because investment in research will save children's lives, which is important to all of us.
	We have already made a start on mental health research by creating the first phase of a research network within the National Institute of Mental Health for England. I am now in a position to give extra resources to expand this network and make it more inclusive. That is critical, because up to now mental health research has not properly informed policy and practice, as too many studies have been too small and too local to permit valid general conclusions to be drawn. Investment in research will therefore help to relieve distress for the mentally ill.
	The Department of Health has worked closely with a wide range of stakeholders to consider other diseases that involve vulnerable groups. I have mentioned particularly children and those suffering from mental illness, but I also want to mention other diseases that involve vulnerable groups or that have associated with them a high level of underlying health need and potential to bring rapid benefit to patients through research. Consequently, in addition to the research already outlined for children and the mentally ill, some of the additional resources for research will be put into three diseases which result in a disproportionate burden on our elderly population: Alzheimer's disease, stroke and diabetes. Investment in this research will also save lives and ease pain and distress.
	We intend that these clinical research networks should use the extra investment to enable research to be conducted across the full spectrum of disease and clinical need. Research that saves the lives of the public costs investment.

Paul Burstow: In relation to the Secretary of State's reference to strokes, why did it take the Department and the Committee on Safety of Medicines two years, from notification of the relevant authorities in Canada that prescribing anti-psychotic drugs to elderly people in care homes results in a threefold increase in strokes, to withdraw those drugs from being prescribed to older people in this country, thus causing many additional strokes in this country? [Interruption.]

John Reid: No, I will hesitate to blame my predecessor—[Interruption.] No, it is because it is always more accurate and efficacious to blame the preceding Government than my predecessor. In this case, the hon. Gentleman has asked a serious question. If I understood it correctly, the information to which he referred was finally decided only relatively recently—in the past few weeks, I think—and brought to my notice. Within about seven days of its being brought to our notice, as a final conclusion of the relevant committee, we released that information into the public domain. I think that that is what he was addressing. If he was asking about another topic, I will certainly write to him. I assure him, however, that we acted as speedily as possible on receipt of that information, although I know that there was a dispute involving one expert in particular.
	I was making the simple proposition that research saves the lives of the public, and research that saves the lives of the public means investment. It costs money. It cannot be done without the Government, who are committed to such research, providing the resources.
	That investment is as much an integral part of the NHS as paying the wages of a front-line doctor or a front-line nurse. It provides those front-line staff with the tools with which to do their essential work. Investment in medical research, therefore, is an inherent, integral and vital part of the contribution that the national health service makes to the people of this country. I wait with interest to learn what commitments will be made by the Conservatives in terms of resources for this vital area.
	In general, we have funded investment in the NHS during the past few years at an unprecedented level, over an unprecedented and sustained period, to produce an unprecedented increase in capacity which in itself improves the accessibility, quality and degree of power, information and choice for all beneficiaries of the NHS. Let us contrast that with the Conservatives' plans. Let us contrast our ambition and vision for this national health service of ours with a miserable lack of either vision or ambition. That was evident even before the Budget statement: we knew of their plans to divert some £2 billion of taxpayers' money away from the national health service, which benefits everyone, to passports for the few who are privileged and rich enough to buy half the private operations in the private sector. Now, in the face of the Government's belief in the NHS, their plans are even more exposed: we see them in their threadbare entirety.
	We will invest in the front-line staff of the NHS. The hon. Member for Mid-Worcestershire (Mr. Luff) laughs. He would not laugh if, like me, he had to meet every week of the year people who have been waiting scandalous amounts of time for operations in the NHS because of 20 years of chronic underfunding by the Conservative party. It is no laughing matter when loved ones must wait in pain for cataract operations or hip replacements. We will take no sneering cynicism from the Conservatives when it comes to running down the health service.
	We will invest in front-line staff, but we will also invest in the scientific and research base of the NHS. To us, science and research constitute a front-line service, as they, too, reduce distress and pain and save lives. Members should contrast the Conservatives' ambivalence with our commitment. We believe in the national health service, and just as we have always taken pride in its past, we have faith in its future. We back that confidence with commitment and with investment on behalf of the country. What a pity that the Conservative party cannot bring itself to provide either.

Tim Yeo: I begin by drawing attention to my entry in the Register of Members' Interests.
	The Secretary of State spoke for 42 minutes. I think that Members in all parts of the House, as well as observers outside Parliament, will conclude that his having spent so little of that 42 minutes explaining what is going on in the NHS and what is happening to the nation's health suggests that he realises that the Government's record contains a great deal of which he should be ashamed.
	This is a Budget debate, and I am sure that many Members will wish to range widely over all the issues raised in the Budget—including, in particular, the inevitable third-term tax rises that the British people will have to pay if Labour continues in power. I, however, will focus primarily on health.
	Let me start with a statement of principle. Like all my colleagues in the shadow health team and like the Conservative party as a whole, I am utterly committed to the national health service and to its founding principle.

John Reid: Will the hon. Gentleman give way?

Tim Yeo: The Secretary of State had 42 minutes. I have had less than one minute.
	We are utterly committed to that founding principle—that care should be available to patients on the basis of need, not on the basis of ability to pay. So there should be equal access for all, free at the point of delivery. That principle has been reiterated by my right hon. and learned Friend the Leader of the Opposition, by my right hon. Friend the Member for West Dorset (Mr. Letwin), the shadow Chancellor of the Exchequer, and by me on many occasions. It lies at the heart of all our health policies.

John Reid: Will the hon. Gentleman give way?

Tim Yeo: I will in a moment. The Secretary of State must contain himself. He had 42 minutes; when I have had a minute or two to develop this point, I will give way.
	Every part of the Conservative party's health policy will reinforce that founding principle. Although the Chancellor of the Exchequer referred in his Budget speech to increases in spending on health, there was no change, either up or down, in the spending plans that he had already announced.
	Following the speech by my right hon. Friend the Member for West Dorset last month, I can confirm that, in the first two years of the next Parliament, the newly elected Conservative Government will match the present Government's spending plans for the national health service. That means that we no longer need to waste time arguing about how much money will be spent because, regardless of the outcome of the election, spending on the national health service will increase by broadly the same amount. Instead, we can get on to the more crucial subject of how that money is spent. For the avoidance of doubt, let me make it clear that the aim of extra spending under the Conservative Government will be to benefit national health service users, including patients who are on national health service waiting lists. I can announce that it will not be the policy of the next Conservative Government to offer tax relief to people who take out private medical insurance.

John Reid: Since the hon. Gentleman is so committed to equality of access being granted through public money, will he confirm today that someone who does not have the £9,000 to pay towards a private sector heart bypass operation will nevertheless have equal access to that private sector heart bypass operation, costing £18,000, compared with someone who does have £9,000 in their bank account? Does the hon. Gentleman understand that? I am explaining to him the terms of his own policy—the patients passport. Will he confirm that someone who cannot afford to pay £9,000 to meet half the cost of a heart bypass operation performed in the private sector will nevertheless be entitled, the same as everyone else, to that heart operation in the private sector?

Tim Yeo: My understanding is that that is exactly what the Secretary of State proposes. If people have been waiting long enough, they will be allowed access to the independent sector. [Interruption.] Is he not allowing that?

John Reid: The Secretary of State—i.e. me—is proposing that anyone who has an operation in the private sector will pay nothing towards it. Therefore, everyone, irrespective of how much money they have, will enjoy equal access to treatment. According to the patients passport, a person has to meet half the cost of a private operation in order for the NHS to pay the other half, so can the hon. Gentleman explain how anyone who does not have that money could possibly have equal access compared with those people who have, say, £9,000 for a heart bypass?

Tim Yeo: I am interested in the Secretary of State's clarification of the Government's policy. He appears to be proposing that, even if people are willing to pay £9,000 towards the cost, he will pay the whole £18,000. No wonder the Government are in such a spending mess. If they intend to turn down contributions from people who may be willing to pay, their policy will involve an enormous amount of extravagance.

John Reid: rose—

Tim Yeo: If the Secretary of State would like to wait, let me provide the clarification of the patients passport policy that he may be seeking. It is designed to give patients and their doctors more control over how and where people are treated and it will help to reduce waiting times by enabling all patients to have access to the entire national health service, not just to their local hospital or the hospital to which their doctor says they must go. For the first time, and under a Conservative Government, the national health service will become a truly national service. All aspects of NHS provision will be available to every patient.
	Like the Government, the Conservative party believes that the private sector has a contribution to make in reducing waiting times. Indeed, I read in The Times this morning that the Government seem to think that the private sector has a rather big contribution to make in reducing waiting times—no matter at what cost. We may be a bit more careful about that. The patients passport will therefore also enable NHS patients to gain access to the private sector, to all those independent providers of treatment to whom they have been previously denied access. That treatment will become available to them under the patients passport, and the precise basis on which that access will be granted is a matter on which we are now consulting.

John Reid: The hon. Gentleman is taking advice. You can take advice from anyone you like, Mr. Deputy Speaker, but you cannot square a circle.

Mr. Deputy Speaker: Order. First, the Secretary of State must use the correct parliamentary language, and I suggest that interventions should be a little briefer.

John Reid: I want to ask the same question that the hon. Gentleman did not answer the last time that I intervened. Will he confirm that, even with the public subsidy of half the price of an operation in the private sector, someone who cannot afford the other half will not be entitled to have that operation in that sector? In other words, there will be no equity of access in the NHS for those without the money.

Tim Yeo: Just because the Secretary of State did not like my previous answer does not mean that I will try to give him a fresh one. I have explained exactly what our policy aims to do, what it will achieve and the basis on which it will be available to all NHS patients. I am confident that the public will see the merits of our policy, just as some people have already seen the merits of the announcement that was made a few weeks ago about extending the availability of the patients passport to 17 million patients who suffer from chronic conditions—something that the Government have overlooked and neglected. Shortly after we made it clear that the scope of the patients passport would be extended in that way, I found that it received strong third-party endorsements.

Paul Burstow: Will the hon. Gentleman give way?

Tim Yeo: I must make a little progress; I will give way in a moment.
	Let us consider some of the ways in which progress has been made in improving both the nation's health and the NHS itself. No one welcomes those improvements more than I do. It is excellent news that progress has indeed been made in some respects, and I warmly congratulate all those staff whose hard work has contributed to those achievements—the doctors and nurses, all the other health professionals, the back-up staff and, of course, the managers, too. For example, let me join in welcoming the news, announced by Cancer Research UK, of a significant drop in UK cancer deaths. That progress has been made over the past generation and reflects the work not only of the health staff, to whom I have paid tribute, but of the researchers, cancer charities and fund raisers.
	We are also thankful for the reduction in death rates from coronary heart disease, which must largely be attributed to advances in medicine and technology. The Secretary of State referred to the increased use of statins, which have played an important part in helping to manage the disease, and stents have substantially reduced the requirement for coronary heart bypass surgery. Progress has also been made in providing cataract surgery for those who need it and the waiting times for that surgery are finally showing signs of improvement.
	I am glad that the Government have recognised the part that treatment centres can play in achieving such goals, but while we join in celebrating those good things—of course, there are others that I do not have time to mention—there is another side to the picture, about which the Secretary of State is more reluctant to speak. The fact that he was at such pains to misinterpret Conservative policy will not prevent me from telling the truth about Labour policy.

Alan Milburn: On Conservative policy, the hon. Gentleman is responsible for education policy, as well as health policy, for the Conservative Front-Bench team. Can he explain why it would be permissible, under his patients passport policy, to allow a privately paid top-up for patients to go privately in health, when he would stop that happening under his pupils passport?

Tim Yeo: The right hon. Gentleman tempts me greatly. I noticed the dismay among Labour Members last Thursday, when my hon. Friend the Member for Westmorland and Lonsdale (Mr. Collins) explained in detail the basis of our pupils passport. Indeed, as the right hon. Gentleman says, we have made it clear what the scope of that passport will be. I have made it clear this afternoon that we are consulting on the detail of how the patients passport will be usable in the independent sector. The dismay that the Secretary of State for Education and Skills showed last Thursday may provide us with some pointers about what the Government are afraid might happen as far as the patients passport is concerned.

Alan Milburn: Will the hon. Gentleman explain whether consultation is another word for confusion?

Tim Yeo: In the Government's mind, I am sure that it very frequently is.
	Let us look at the facts. Despite an increase in spending of 38 per cent. since 1999, activity levels in hospitals have risen by less than 5 per cent. We have to consider whether the outcomes that are achieved represent real value for money from the point of view of both patients and taxpayers given the huge rise in spending on the NHS that has taken place. The think-tank, Reform, pointed out in January that the increases in both hospital admissions and out-patient appointments have been slower since 1999 than they were in the previous decade. Despite this 38 per cent. increase in spending, the number of GPs has risen by only 4 per cent. over the period and the number of midwives by only 3 per cent. Where is all the money going? It is going to meet the targets that Ministers keep setting to satisfy the control-freak instincts of new Labour. Managers have had to be hired at almost double the rate of nurses.
	A chunk of the money went on the Modernisation Agency, a typical new Labour invention that was described by the Health Service Journal as the flagship of the Government's health care reforms. The body was formed just three years ago for the purpose of—I quote from the latest departmental report—
	"supporting the NHS and its partner organisations in the task of modernising services and improving experiences and outcomes for patients."
	The same report told us as recently as last July that the agency's focus this year would be
	"to maintain its innovation and to make modernisation move into the mainstream of the NHS."
	Earlier this month, however, we learned that the agency now faces the axe. I wonder just what it has been doing. Was it the Modernisation Agency that decided that student nurses should, as part of their training, have to spend time drawing pictures of how they imagined themselves as pensioners, writing advertisements for themselves as friends, describing how their enemies might view them and looking at the psychology of peasants in Russia? Was it the agency that concluded that outcomes for patients would improve if a student nurse nearing the end of her second year of training had done all the things I have just mentioned but had not been taught how to put up a drip, insert a catheter or administer or take blood? Does modernising the NHS mean that student nurses need only a one-and-a-half-hour group lesson on injections before being let loose on the ward?

John Hutton: These issues have nothing to do with the Modernisation Agency.

Tim Yeo: The Minister suggests that this has nothing to do with the health service, but I hope his Department will not claim that it is not aware of those facts. They were all set out in a letter sent to the Secretary of State by a student nurse in London last month, a copy of which was sent to me.

Stephen McCabe: Given the hon. Gentleman's analysis, can he tell the House, based on his calculations, how much he estimates he could safely remove from the NHS budget without doing any damage to current levels of patient treatment or care?

Tim Yeo: I am sorry that the hon. Gentleman has clearly not been listening to what I have said. The next Conservative Government will, in the first two years of the next Parliament, match the spending plans left behind by the Labour Government. I am confident that, in that period, we will identify further significant savings because of the extravagance and waste that the policies of the present Government have resulted in. We may then be able to discuss how to use those savings, some, most or perhaps all of which will be available for improved patient care.
	To return to the Modernisation Agency, we cannot be sure how much taxpayers' money was spent on this very short-lived exercise, but I have seen a press release that suggests that the figure was well over £500 million. That sounds like an expensive three-year experiment. The Modernisation Agency, however, was a positive veteran when it got the chop compared with the National Care Standards Commission. That body had been going for only 18 days before it was told that it was going to be abolished. With an approach as chaotic as that, it is no wonder that patients despair of seeing the money that they are paying as taxpayers actually reaching the front line.
	It is not only the way that incompetent Ministers waste money second-guessing managers and chasing headlines that is the problem. In too many areas, we are simply not making enough progress. Derek Wanless, the man chosen by the Chancellor to report on the state of the nation's health, pointed out some of the harsh realities that Ministers prefer to sweep under the carpet. Death rates in England from respiratory diseases are worse than those in France, Sweden, Denmark, Canada, Australia, Finland, Germany and Holland, which are all countries with similar population structures, health care systems and per capita wealth to those of England. Britain also has the worst infant mortality rate among those countries and the second highest death rate from cancer in women. Incidentally, for 34,000 sufferers from ovarian cancer, the mean waiting time is almost 50 per cent. longer than in 1999.
	Deaths from MRSA—the hospital superbug—have more than doubled since 1997. Less than a month ago, the chief medical officer called that "shocking and unacceptable". That is a reflection of the fact that after seven years of a Labour Government, Britain has one of the worst rates of hospital-acquired infections in the western world. People are more likely to catch an infection in a hospital in Britain than in a hospital in France, Germany, Holland, Belgium, Spain, Italy, Sweden, Austria, Denmark or Ireland, as 100,000 people every year find out to their cost. Was that what the Prime Minister had in mind when he told voters seven years ago that there were 24 hours left to save the national health service? Labour promised that the money that it spent would allow it to get the basics right. Its inspection teams have given hospitals the all clear on cleanliness, but as today's edition of The Sun informs us, the truth is a very different story indeed.
	Let us take tuberculosis. According to data released this month by the Health Protection Agency, TB in England and Wales has increased by a fifth since 1999. The chief medical officer points out that the rate of TB notifications in the London borough of Newham is worse that those of India and Romania. What has happened to the TB action plan, which we were promised would be in place early last year?
	It is not only health outcomes that are worrying. In the last full year, the number of cancelled operations was significantly higher than in 1997. The latest quarterly figures show scarcely any improvement in the current year. Cancelled operations can be the result of a shortage of available beds, and there are 20,000 fewer beds now than there were in 1997. With more than 70,000 care home places lost since 1996, many because of Labour's obsession with over-regulation, it is no wonder that people are now queuing to get out of hospital as well as to get in.
	Ministers like to tell us about the fall in the number of patients who have been waiting very long periods to go into hospital, but only last month, the chief executive of the national health service confirmed that average waiting times have actually increased. At the present rate of progress, it will take more than 60 years to clear the waiting lists.
	Out in the community, things are not much better. The number of people receiving domiciliary care has fallen by almost 100,000 since 1997, which is a drop of more than one fifth. The number of health visitors is lower than it was under the Conservatives. The number of district nurses is also lower, and the number of people receiving community mental health care has fallen by almost 8 per cent. since 1997.
	Even when the Prime Minister himself makes a promise, the situation is no better. At Labour's 1999 party conference, he promised that everyone would have the
	"chance to see their dentist".
	Eight months later, the NHS plan said that the Government were
	"firmly committed to making high quality NHS dentistry available to all who want it by September 2001".
	However, like so many of the Prime Minister's promises, that one, too, has been broken. The proportion of English adults registered with an NHS dentist has fallen substantially while Labour has been in power.
	Whenever Conservatives start to tell the truth about what is happening to the health of the nation, Ministers accuse us of talking down the NHS, but nothing could be further from the truth. We have the highest admiration for the dedication and professionalism of the thousands of people who work in the national health service, and I know that my views are shared by millions of patients. However, we all know that despite all their hard work and the fact that some progress has been made, the NHS could, and should, be better. Today, after seven years of the Labour Government and vast increases in spending, people whose hopes were raised so high are clearly and understandably disappointed. As an ICM poll showed last September, more than half of those surveyed thought that the NHS had got worse since 1997 and less than a third thought that it had got better.
	The biggest obstacle to the further progress for which we all yearn is the attitude of the Secretary of State and his ministerial colleagues. [Interruption.] His meddling ways prevent front-line staff from getting on with the jobs that they have been trained to do. His insistence on targets frequently distorts clinical judgments and often has perverse consequences, like the waiting time target for new out-patient appointments at the Bristol eye hospital, which led to other follow-up appointments being delayed or cancelled, with the result that 25 people went blind. It is no wonder that morale among professionals is so low and frustration is so high. Last month, 500 doctors paid for an advertisement in which they said:
	"We once believed the NHS was the finest healthcare system in the world. Today few healthcare professionals would make that claim."
	The Secretary of State would like us to believe that he and the rest of the Government are about to mend their ways. [Interruption.] He promises that Ministers will set fewer targets, but in a supplement to the Red Book published last week, a report from the Cabinet Office highlighted—

Mr. Deputy Speaker: Order. Treasury Front-Bench spokesmen must not keep intervening from a sedentary position. Although a certain amount of latitude is allowed, today we are debating not Opposition policies, but the Budget.

Tim Yeo: I am afraid the fact is that Government Front-Bench spokesmen do not like to hear the facts about how they run the health service and the damage that they cause to the health of the British people.
	The report from the Cabinet Office highlighted that
	"many organisations do face excessive externally set targets, measures and compliance requirements".
	It continued:
	"the Department of Health has only 12"
	public service agreement
	"targets across the NHS and Social Care. Front line trusts and PCTs however face more than 4 times as many PSA-related controls . . . with a further 125 non-PSA related controls".
	So although the Department of Health claims to have only 12 key targets, the overall number of targets with which those on the front line have to comply is 17 times greater.
	The Secretary of State promises that bureaucracy will be reduced and that staff numbers at his Department will be cut. He promises that patients will be given more choice. Those promises, however, are at odds with the Government's instinct for control freakery. Ministers may talk a good game, but the row over foundation hospitals showed just how reluctant the Labour party actually is to allow any genuine freedom to the providers of health care. We are now asked to believe that the very Ministers who presided over a rampant growth in bureaucracy are the best people to tackle the problems that they created. We are asked to believe that the same Ministers who have been obsessed with setting targets, through which they have tried to control every detail of the delivery of health care, will now allow clinicians and managers freedom to do their jobs.
	As for patient choice, the improvements that the Government have promised will be available only to patients on a limited scale and after they have endured long waiting times. The danger is that if the Government's preoccupation with acute and emergency care continues, the needs of the 17 million people with long-term medical conditions will again be neglected. Earlier this month, the Secretary of State suddenly woke up to the fact that most of his targets have overlooked the suffering of those people and their families, but it will take more than a speech about "integrating the care landscape" to tackle the problem. That is why my colleagues and I have opened a dialogue with the Long Term Medical Conditions Alliance.
	Mental health is another neglected area. More than 18 months after the end of the Government's consultation on the draft mental health Bill, we still await publication of the responses. Meanwhile, services continue to suffer. The NHS plan promised to introduce 335 crisis resolution teams by 2004, but fewer than half are in place. Some 50 early intervention teams were promised to reduce the period of untreated psychosis in young people and to help to improve long-term outcomes. Only 27 have been established.
	Public health is another subject of deep and growing concern. I mentioned the rise in TB. Obesity is another problem that is growing worse under this Government. Last month's report from the Royal College of Physicians, the Royal College of Paediatrics and Child Health and the Faculty of Public Health contained a clear warning about where present trends are leading. The British Diabetic Association issued a similar warning.
	The Government's response to these worsening trends is chaotic. Faced with growing concern over obesity, Downing street floated the idea of subsidised gym club membership and a tax on fatty foods. Those wheezes succeeded in getting a headline but little else, and perhaps that is all that was intended. The ideas were soon rubbished by the Treasury's public health guru, Derek Wanless, but, having called for a report on public health, the Chancellor made no mention of that in his Budget. Meanwhile, the Department for Culture, Media and Sport has at last discovered that sport in schools is a good idea after all. As for the Secretary of State for Health, he is so confused that the only thing he can think of is to ask the public for their view—another big conversation when what the public need are answers. Who is supposed to be in charge? These issues are far too important to be dealt with in this muddled way. A co-ordinated approach right across Government is needed, and the Secretary of State should take responsibility, but taking responsibility is something that Ministers in this Government are extremely reluctant to do.
	Last week, the Chancellor was so busy patting himself on the back, he did not mention that each time he makes a statement to the House the amount of money that he has to borrow to pay for his spendthrift ways increases. He has presided over the biggest trade deficit since records started over 300 years ago, a halving of the rate of productivity growth compared with the last Conservative Government, the destruction of hundreds of thousands of jobs in manufacturing and a collapse in the savings ratio, and he has ruined the expectations of thousands of members of occupational pension schemes. One would search his Budget speech in vain for any reference to those important facts, just as one would search in vain for any admission of the inevitability of tax rises in the next Parliament if Labour wins another term.
	I have given credit where it is due, especially to the dedicated and hard-working staff in the NHS. I have acknowledged that progress is being made in some respects, but to make real improvements to the nation's health a different approach is needed. With the founding principle of the NHS as our starting point we will make far-reaching and radical changes to the way that health care is delivered: by giving patients more control and freedom within the system; by giving genuine independence to health care providers; by having a much clearer focus on public health, the one aspect of health policy which should be delivered from the centre; and by launching a vigorous attack on waste at every level. It will not be enough merely to give patients more say in how and where they are treated. We must give more freedom to the providers, too. We want to give professionals, doctors, nurses and others working in health, including managers, freedom to do the jobs that they have been trained to do.
	We will abolish the star ratings and most of the Whitehall-set targets through which Ministers have constantly meddled with the NHS, often to the detriment of patients' interests. At the next general election the country will have a clear choice when it comes to health: either continue with Labour's wasteful ways, in which standards in Britain lag behind other countries, an over-centralised system demoralises staff, and patients are denied control because Ministers think that Whitehall knows best, in a system where the state is too large and patients are too small. Or follow the new Conservative path, which will transform the way that health care is delivered, ensure that taxpayers' money reaches the front line, put patients in control and let doctors and nurses do their job. That is the choice that we will offer the people of Britain.
	After seven years of tax, waste and spin, the public cannot see where all their money has gone. They know that the Government have not delivered on health, the Labour party knows that the Government have not delivered on health and the Secretary of State knows that the Government have not delivered on health. We relish the opportunity to offer the people of Britain the first-class health care that they have paid for and deserve.

Mr. Deputy Speaker: Order. Before I call the next speaker, I remind the House that there is a 15-minute limit on Back-Bench speeches, and that applies from now.

Alan Milburn: It is a privilege to speak after my right hon. Friend the Secretary of State for Health, and I welcome his extremely important announcements. Would that I could say the same about the hon. Member for South Suffolk (Mr. Yeo), whose speech almost made me long for the return to the Dispatch Box of the hon. Member for Woodspring (Dr. Fox). I suspect that the reason for concern on the part of Opposition Members, which was perhaps reflected in the hon. Gentleman's speech, is that last week's Budget was one of not only considerable economic acumen but considerable political acumen. Few right hon. and hon. Members who listened to my right hon. Friend the Chancellor of the Exchequer could have doubted that they were hearing the starting pistol being fired for what promises to be an extremely long and interesting general election campaign.

Peter Luff: On a point of order, Mr. Deputy Speaker. I think that the right hon. Gentleman will be grateful to me for raising this matter. There is a considerable problem with the sound system in the Chamber today, and I think that I have guessed correctly that the Hansard writers are having some difficulty hearing him. Can you do anything about that?

Mr. Deputy Speaker: I think that we shall simply have to carry on and use our voices as they did in days of old.

Hon. Members: Hear, hear!

Alan Milburn: I shall shout at the Opposition—I have done a bit of that in my time.
	The Opposition's locker, which looked reasonably full only a few weeks ago when the shadow Chancellor published the Conservatives' spending plans, looked decidedly empty once the Chancellor had delivered his Budget. I have to say that it never struck me as credible that the Conservative party, purportedly committed to strong defence and law and order, could go into a general election campaign promising cuts at the Ministry of Defence and the Home Office. The truth is that the Budget has made its position even more painful, because the choice that it faces is whether to enter that campaign promising to take extra resources out of education to pay for tax cuts. The Budget has made the choice for the electorate even more stark: cuts in taxes, or investment in services. It was James I of England who was famously described by Henry IV of France as
	"the wisest fool in Christendom."
	The shadow Chancellor may well have laid claim to that epithet now.
	Sixteen years ago almost to the day—in fact, I think the anniversary was yesterday—Lord Lawson, then Chancellor, hailed in this House what he called an "economic miracle". As we now know, his words were to turn to ashes in his mouth within a few short years, as economic mismanagement led inexorably to economic recession. When Lord Lawson spoke, the economy was doing reasonably well, but almost 2.5 million people were none the less unemployed and the inflation rate was just shy of 5 per cent. Today, by comparison, unemployment and inflation are roughly half that. I am not especially religiously inclined, so I do not say that what has been achieved in recent years is miraculous, but it is pretty remarkable. In the midst of a worldwide economic downturn, the British economy has continued to grow year after year, quarter after quarter. Even the most jaundiced economic commentators have been forced to concede that the fundamentals—inflation, interest rates, debt and jobs—are sound. I say that because there is sometimes a temptation to take all the progress for granted, as though it were purely natural. As even a cursory glance at the plight of some of our competitor nations, or at our recent economic history, shows, that is not so: Britain is in a good position because of good economic management.
	We cannot hope to compete on pay or prices with the likes of China or Taiwan. Our future is not at the low-tech, low-skills end of the world market; it lies in high-skill, high-tech services and industries. That is why I applaud the Government's decision to invest further resources in education, just as they have in health. The investment being made in public services is not simply about creating more opportunity for better health and better education, important though they are. Nor is a social dividend all we will reap from that investment, as better-educated citizens lead healthier lives. There will be an economic dividend as well. In the short term, it will come from the stimulus that spending provides to the economy. Oxford Economic Forecasting Ltd. estimates that current spending will boost GDP growth by at least 0.8 per cent. this year and, indeed, next year. It is sound long-term economics for low-debt countries such as our own to be able to borrow so as to invest for the longer term. Providing that our expenditure plans are affordable, which I believe them to be, then public spending—far from being always a burden as too many assume, including, tragically, the Conservative party—can be a benefit. The long-term benefits are even more significant.
	The primary rationale for investing more in health is to relieve pain and extend life. There are also important economic spin-offs. Many historians have noted that perhaps one third of per capita growth over the past two centuries in this country resulted from improvements in nutrition and health status. In a modern, knowledge-based economy, there is an even bigger premium on good health. When the Institute of Directors, not normally known for its political radicalism, still less for its adherence to Keynesianism, says that sickness is a hidden tax on business, undermining competitiveness and reducing productivity, it really is time to take note. The number of long-term sick and disabled people wanting a job but not presently looking for one has more than doubled in the past decade. In an economy that is moving towards full employment and already reporting labour shortages, such morbidity levels pose a real threat to future growth.
	That is why my right hon. Friend the Secretary of State for Health is right to insist on improvements in NHS responsiveness to reduce waiting times for treatment. That will deliver not only a health benefit, but an economic benefit. It is one of the reasons why I also welcome my right hon. Friend's renewed focus on public health and prevention. In time, too, it will make a positive contribution to the UK's longer-term performance.
	If health investment performs an economic function, the same argument can be advanced in spades for education investment. In the United States, it is widely accepted that every dollar invested in early years provision brings a sevenfold payback in lower crime, higher educational attainment and, most importantly, better jobs. Our Government have much to be proud of in that regard, providing extra nursery places and Sure Start projects in constituencies such as mine.
	The Budget promised yet more child care centres. That, too, is welcome. However, in a country in which rising economic prosperity means that there are more two-income earners and more families struggling to balance their working lives and family lives—I speak with some experience about that—child care cannot just be centred on institutions. It must be centred on parents' needs. Above all else, working parents say that they need child care that is affordable and flexible. That is why I hope that the Government will go further than the Budget by ensuring that parents have a choice in how they receive help with child care.
	For some, that care might be in a nursery or a child care centre. For others, it might be in the home. The point is that a one-size-fits-all approach will not work. Nowadays, people need flexible, personalised services. It is vital that choice is widely extended, not only in respect of child care, but for the wider public services. In that way, we shall get services that are not just more responsive but more fair. When we extend choice in the NHS, as my right hon. Friend is rightly doing, so that it becomes accessible to those without the ability to pay for treatment, as well as to those with that ability, and when we ensure, as I hope we will, greater parental choice over schools for those without wealth as well as for those who have it, we will be redistributing opportunity in our society. Today, people who can afford it buy choice in health and education. Those without do without. That is unfair, and it must be a Government priority to change that.
	I suggest one further area where this modern form of redistribution should be taken forward, and that is housing. The promise of more resources in the Budget, alongside the Barker review of housing supply, is welcome and long overdue. Quite simply, our country is short of houses. The result, as Kate Barker rightly points out, is a negative impact on labour mobility. In a modern global economy, such inflexibilities exact a high price, but my principal concern is more social than economic. Over the past four decades, social mobility in our country has slowed markedly. The generation of children born, like me, in 1958, were far less dependent on the economic status of their parents for their eventual economic progress than those born just 12 years later in 1970. Birth, not worth, has become more and more a key determinant of life chances, and sadly, changes in the housing market are opening an ever larger gulf between those with assets and those without.
	Rising house prices are making home ownership more unaffordable for more people. Not surprisingly, the number of first-time buyers entering the market has declined. In the longer term, rising house prices threaten to impede social mobility across generations. While the value of housing assets has increased markedly, the number of people with no assets at all has more than doubled in the past 20 years. The principal inequality in our society today is no longer about income but about ownership of assets, whether a pension or a home. In London today, the child of a home owner stands to inherit an average of £230,000 when the parents die, but a classmate whose family rents will inherit nothing. In other words, the housing market is widening inequality.
	It must therefore be the Government's explicit objective and priority to increase home ownership. I agree that more social housing is needed, but I do not agree with the orthodoxy that the only future for those without a home lies in social housing. When interest rates are low, it is often cheaper to buy than to rent. Moreover, given a choice, most people prefer to buy rather than rent. Welcome as the Barker report is, we need to do more than simply build more homes; we need to open up more opportunities for people to own their own homes. Helping people on to the housing ladder will not only address issues of labour mobility and economic flexibility, but be a route to greater social justice and fairness in our country. It is a modern means of redistributing wealth in our society. The job of a progressive Government is not just to beat poverty but to help people realise their aspirations so that we are capable of levelling up in society, not levelling down.
	New Labour won in 1997 and 2001 as a party of aspiration. Future victories depend on our pursuing policies that promote aspiration and enhance choice. That requires investment, of course, but also reform, whether in health, education or housing. Good foundations have been laid, and the Budget builds on those foundations. Its proposals for extra resources are welcome, as investment, not tax cuts, can best secure the long-term prosperity of our country. A flexible economy and a fluid society, however, cannot be bought simply by increasing resources. With investment rising, it is time to put our foot firmly on the accelerator, not on the brake, for reform as well, and I hope that my right hon. and hon. Friends will do so.

Paul Burstow: I should like to start by making some comments about the NHS, and then address other issues in the Budget, particularly preventive health.
	Liberal Democrats support investment in the national health service. At the last general election, we had the courage and conviction to argue the case for increased taxation. We are delighted that that argument has been won—during this Parliament, the necessary resources have finally been provided and we voted for the increase in national insurance that was approved by the House about a year ago. We wish to place on record our appreciation for the dedication and hard work of NHS staff, both on the front line and in the back office. It is important to stress the commitment of both groups and to register our appreciation, not least because the recent survey by the Commission for Health Improvement found that one in six front-line health care staff are victims of abuse and violence when performing their job of caring, nurturing, supporting and trying to help sick people get better. It is entirely unacceptable that staff should be thrown into that battlefield when they already have more than enough stress and worry in the discharge of their duties.
	There was a disappointing if predictable reaction to last week's work force survey, particularly the findings about the increase in the number of managers. Some people have a fixation about what those figures mean, how they are interpreted and what they show, but it is worth bearing it in mind that between 1997–98 and 2002–03, the management costs of the NHS fell from 5 to 3.9 per cent. I do not buy the argument that the NHS has too many managers, and nor do I buy the statistics that are often peddled to justify that argument, because they require a stripping-out of various staff who provide back-up support for front-line staff. However, NHS managers who are trying to do their job have their hands tied by red tape supplied by Whitehall and by the excessive number of targets that determine what goes on at local level to enable people to have choices about initiatives. That undoubtedly stifles the opportunity for innovation in the NHS at local level. It is only by freeing NHS managers and staff from the target and tick-box culture that still drives too much of the NHS from Whitehall that we can hope to get the full value of the investment that is going in. The Commission for Health Improvement commented on that only last week.

John Reid: May I place on record my gratitude to the hon. Gentleman for giving the lie to the constantly peddled myth that the NHS is over-managed? Does he accept that the percentage of managers in the NHS is, at under 3 per cent., far lower than in the private health care sector or the private sector? Since 1997, 224,000 more staff have been recruited, of whom 13,000 or 5 per cent. are managers. I wish to underline the distinction that he made between the task that managers face and the myth often peddled by the Conservatives, which is merely another way to beat the NHS. Their figures for managers are manufactured and are frankly not true.

Paul Burstow: I am grateful to the Secretary of State. While I have many disagreements with him about priorities and approach, he is right on that point. It is important to put on record the facts about management, because a myth is being spread about the inappropriate deployment of money, which, it is said, is not reaching the front line. There are, however, some examples of money not reaching the front line, which I shall deal with in a minute.
	I mentioned the work force survey, and it is worth looking at one or two of its findings. Last week, there was some premature back-slapping about the progress that has been made. Undoubtedly, additional nurses and doctors have come into the national health service, which is welcome, but there are still grounds for serious concern, not least because of the demographic profile of the nurse population in this country. One in four nurses will be eligible for retirement in the next five years, and recruiting more nurses to replace such large numbers will be a hell of a challenge. Our health care system is increasingly dependent on the recruitment of nurses from overseas. I shall not address the ethics of that now, although there are still concerns about overseas recruitment. We are, however, competing for health care staff in a global market where other players are probably better equipped than we are to compete for our precious health care staff. The United States of America currently has a shortfall of 1 million nurses, and is trying to get UK nurses to work there. Plenty of other countries are likely to do the same thing. Health care recruitment is a global problem, and I do not yet see any international action being taken to ensure that we have an adequate supply to meet the needs of developed countries and to secure the long-term needs of developing countries.
	I shall focus on some of the other figures that emerged from the work force survey. For example, the number of midwives continues to be a cause for concern. The continuing shortage is hitting three quarters of maternity units, where vacancy rates have remained stubbornly high or have been rising since 1999. Given the importance of strengthening primary care, it is particularly worrying that the survey recorded a drop in the number of health visitors and district nurses. A report this month from the Commission for Healthcare Audit and Inspection draws our attention to the continuing crisis in the development and delivery of primary care, and the fact that staff shortages are leading to GPs closing lists, low staff morale and high workloads. All those factors jeopardise and slow down the development, expansion and improvement of primary care.
	Although we celebrate the investment going into health care, it is worth putting on record the fact that there are a number of areas where taxpayers have every right to question whether they are getting value for money. The first such area is NHS spending on temporary doctors and nurses. Every day, £4 million is spent on agency staffing in the NHS. Last year, £1.4 billion was spent in the NHS in that way. Of course it is sensible to spend on agency staff as part of a strategy that makes the best use of permanent staff, but as the Audit Commission revealed only a couple of years ago, too many NHS trusts have lost control of their agency budgets, have no idea how much they are spending, and have no sense of direction and strategic purpose behind that expenditure. Consequently, they are fighting fires, never getting the budget under control. Year after year under this Government, expenditure on agency staff continues to rise.
	There are other areas where there is cause for concern about whether the taxpayer is receiving value for money. The figures for MRSA infections were reported yesterday and today. A few years ago, the National Audit Office reported that hospital-acquired infections were costing £1 billion. At least 100,000 people suffer from such infections, and possibly as many as 5,000 die every year—the Conservative health spokesman referred to those figures. It is fair to say that under the last Conservative Government, there was still a voluntary surveillance system that did not adequately convey to the NHS or anyone else the scale of the problem. It is only in the past few years that we have had a mandatory reporting system, which has provided a true picture of the scale of the problem: it is massive.
	The result of the failure to get to grips with the problem of infections over the past decade or more is that people stay in hospital for longer. That has knock-on effects: operations are cancelled because people who have got sicker while in hospital occupy beds. According to figures from the Department of Health, 17,000 patients had operations cancelled this winter. The number of operations cancelled has increased by 43 per cent. since 1997, so capacity is being wasted. It is not just a question of investing in more capacity; we must make sure that we use practices that avoid the wastage of existing capacity. Poor hygiene practice and under-resourced infection control teams make it difficult to overcome the problem.
	I shall give a final example of an area where there is waste and room for much improvement, and which is costing the NHS a fortune. Every day, the NHS spends £2 million on treating the consequences of bed sores, which are eminently preventable in about nine out of 10 cases. The annual cost is £750 million and the vast majority of those cases could be prevented by simple practices and good nursing.
	We heard an exchange between the Secretary of State and his Conservative opposite number, the hon. Member for South Suffolk (Mr. Yeo), about the Conservatives' plans for a patients passport. I regret that, despite the Secretary of State's best endeavours, we were unable to get any further clarification of what the policy means and, crucially, how the deadweight cost of the policy will be funded. Some 300,000 people already choose to have operations and other procedures in the private sector. They will be the first people banging on the door of a putative Conservative Secretary of State and saying, "Where are my patient passport pounds? I want them now."
	The scheme would cost £1 billion, on a reasonable estimate. I understand that when the shadow Chancellor made his presentation, he was asked how it would be paid for. He said that the Conservatives did not yet know how much it would cost or how they would pay for it. I certainly hope that the consultation that the hon. Member for South Suffolk outlined will spell out in detail how they will fund that deadweight cost. A billion pounds will be passported out of the NHS, and not a single extra operation will be performed as a consequence. In their quest for savings, the Conservatives should identify that as a waste of money, as should the Secretary of State.

John Reid: Is the hon. Gentleman telling us that the Conservatives do not know how much the scheme will cost, do not know where the money will come from, do not know whom it will go to and think that it is compatible with equity and equal access, even though it depends on how much money people have?

Paul Burstow: I had hoped the right hon. Gentleman would direct that question to his Conservative opposite number. Unfortunately, he did not take the opportunity proffered to him. I would not presume to comment further on Conservative policy, except to say that I look forward to the outcome of the consultation and the publication of the details. Since the policy was published 12 months ago or more, we have been told, "The details are coming. The details are there. Look on the website. Look for the background papers. It's already out there." It is not out there. It is a bit like the secret files that we see in television programmes. Perhaps we need to get the FBI in to look for the X-file details.
	Another topic that the Government plan to introduce over the next couple of years, and which they are piloting in foundation trusts, is payment by results. I hope that before rolling it out across the NHS, various issues will be addressed. The first is the decision to introduce a fixed-price tariff. The Government want competition on the basis of quality, not price, but the problem with the tariff in its current form is that trusts that for some reason—in some cases purely for historical reasons—have costs that are 20 per cent. below the average tariff will receive a substantial sum for no extra procedures or extra activity—a bonus for them at the taxpayers' expense.
	I ask the Government to think again about whether that is the best way to use the extra investment that is going into the NHS, and whether there is some scope even now for a maximum tariff, rather than an average tariff, to allow flexibility and to allow local commissioners to ensure that taxpayers get good value for money, alongside good quality care.
	The second concern about the plan is that everything appears to be tied to the tariff, which could undoubtedly trigger some of the problems that arose from the Conservatives' internal market, where trusts find themselves above tariff, unable to make a transition back to the average within a reasonable time and consequently get into serious financial difficulties. There has been talk of transitional arrangements. Will those apply to the entire NHS, rather than just the pilots?
	The third concern arises from the way the system focuses on rewarding activity, which is not necessarily the way to measure a system designed to promote good health. The system currently provides an incentive for more procedures and more treatment, rather than rewarding the postponement and prevention of ill-health. That brings me to the Wanless report and prevention, on which the Government and the House should focus more.
	I was surprised that in his Budget statement last week, the Chancellor made no reference to the report by Derek Wanless, which, if I read the foreword to the report correctly, was commissioned by the Chancellor, the Secretary of State and the Prime Minister. The first report published by Wanless set out three scenarios. It predicted a gap between the best and the worst-case scenarios of £30 billion by 2022. It said that the NHS would cost £30 billion more if we failed fully to engage people in their own health. His second report sets out with great clarity the fact that the NHS is, by its very nature, focused on treating and curing ill health, rather than on preventing it. Wanless records that we have known for 30 years or more the determinants of ill health—economic, environmental and social factors—and the fact that poverty, poor housing, poor environment, bad diet and lack of exercise are the underlying drivers of much of the ill health that turns up in accident and emergency units and GPs' surgeries.
	The inequalities that the right hon. Member for Darlington (Mr. Milburn) mentioned came across very powerfully in some recent work done in Leicester on health inequality. It found that within a distance of only seven miles, life expectancy varied by 20 years. How can such a difference be acceptable in 21st century Britain? Today's debate has so far failed to recognise that we need to move back upstream and tackle the underlying causes of ill health.

Andrew Murrison: What conclusion does the hon. Gentleman draw from the fact that health inequalities appear to have widened in the past few years, rather than contracted?

Paul Burstow: The conclusion drawn from the work done by Derek Wanless is that the failure over the past 20 years to make dealing with poverty a priority has driven health inequality, and that poverty is at the core of much of that health inequality. It was an underlying driver of health problems in the past, and it is now. It was a failure by the Conservatives when they were in office—[Interruption.] If there is no objection, I would like to develop the point as I see fit. When the Conservatives came to office in 1979, they inherited the Black report from the previous Labour Government, but they shelved it because they were not prepared to incur the up-front costs of shifting emphasis, doing what was necessary and investing in prevention.

Andrew Murrison: I have a point of information for the hon. Gentleman: the Black report was published in 1980, so we could not possibly have inherited it in 1979.

Paul Burstow: That is a very pedantic point. The hon. Gentleman knows full well that the report was commissioned under a Labour Government, but came on to the desk of a Conservative Minister, who shelved it. It was not until 1992 that the Conservative Government finally woke up to the needs that existed and published a White Paper. That is the record of the Conservative Government.
	In my judgment, the current Government's record is not much better. When they came to office in 1997, they initiated work through Acheson and they published a White Paper the following year, but they ditched most of the targets from the 1992 White Paper that could have made a difference. There seems almost to have been a period of boom and bust in activity on prevention and public health. We need sustained investment and reform of the sort that the Government rhetorically describe in relation to other aspects of health.
	When I asked the Secretary of State about investment in research, he gave me the same answer as the Under-Secretary of State for Health, the hon. Member for Welwyn Hatfield (Miss Johnson), who is responsible for public health, gave me in the Select Committee on Health a couple of weeks ago. Effectively, they both said, "You'll have to wait for the White Paper; we are not saying anything just now." Last December, however, the Department of Health announced the establishment of a £3.5 million public health research consortium. My concern is that the scale of the task and the lack of an evidence base, which are documented by the Wanless report, necessitate urgent action. Welcome though the £3.5 million is, it is not enough, and the opportunity should be taken to invest further. I hope that, when the Secretary of State publishes his White Paper, he will give that commitment and roll out a programme of investment.
	I want to mention two final issues. The problem with creating a shift from a sickness service to a health service is that the gains are very long term and do not impact on the Government of the day—unless they are so good that they stay in power for 30 years, but that does not happen very often. For example, in respect of cancer deaths, it takes 30 years after giving up smoking before the individual in question has reduced their risk of cancer to the same level as that of somebody who has not smoked in the first place. Welcome though the reported reduction in cancer deaths is, it is the consequence of action taken by Governments over the past 30 years, not only by this Government in the past five years. That is an important and perhaps salutary lesson for us all, and it needs to be borne in mind when we are trying to build a consensus on public health.
	I want also to ask the Minister about the four-year delay in taking forward a key measure on smoking. The Health and Safety Commission's draft approved code of practice clarifies the implementation of the Health and Safety at Work, etc. Act 1974 in respect of passive smoking. It is four years since that measure was introduced, but the Government have remained silent. The measure does not go so far as to say that there should be a ban on smoking in enclosed public places, but it puts in place arrangements that could make a difference to the workers in those places, as well as to the public who do not wish to be victims of passive smoking. When will the Government act on that measure? As Wanless says, education will manifestly not change behaviour enough, because as those who have smoked know, addiction means that the habit is very hard to shake.
	The timing of the comprehensive spending review is crucial, but the White Paper will be published in the summer. Clearly, the Government have already made quite a few decisions about the additional resources that they might need to earmark in order to roll out a public health agenda. If they have not done that, the White Paper proposals that are published this summer will take a considerable time to implement. I hope that I can be reassured on that point and that things will move forward more rapidly.
	My final point concerns chronic disease. The right hon. Member for Darlington was right to focus on long-term morbidity, as the focus must shift not only to preventing ill health, but to the fact that the success of the NHS means that more people are living for longer with disease. The national service framework is in the pipeline and it will do something in that regard. But is it not curious that there has been a failure to commission any work on the prevalence of most of the chronic diseases that the national service framework on long-term medical conditions is attempting to do something about? There has also been a failure to undertake an audit of the work force to find out where the gaps are so that we can start to plug them. As a consequence, the framework will be hamstrung from the day on which it is published in terms of delivering on the very worthy words that I am sure it will contain.
	The large proportion of NHS staff coping with long-term medical conditions is an important factor. Some 17 million people have long-term medical conditions, and they account for 60 per cent. of GP consultations and hospital resources, so it is important that the NSF delivers not only resources, but the clarity that is necessary for planning at a local level. We need to move from an episodic view of health care to one where patients are equal partners in respect of their own health and care. Nothing in the Secretary of State's speech gave people the sense that the Government want to reorientate the NHS around the needs of those with long-term health conditions.
	We support the investment that is being put in, not so much by this Budget as by the previous one. It is essential, but not sufficient. We need to shift the focus from the treat-and-cure system that we have had since the 1940s to one that is much more about preventing and postponing ill health. We need to lift the burden of the targets and tick boxes that bog down the national health service. Above all, we need to bring health and care closer to home. Accountability must be local, because that is the only way in which we can make the NHS responsive to local needs, rather than to what is dictated by Whitehall.
	After seven years of Labour government, this Budget has failed to set a framework to ensure that our constituents have access to a world-class health care system that not only treats them when they are sick, but ensures that they can enjoy opportunities for good health.

Kelvin Hopkins: I congratulate my right hon. Friend the Chancellor on committing the Government once again to increasing real-terms spending on health and education. We still have a long way to go, although much improvement has already become evident.
	There has been some debate this afternoon about the efficiency of the national health service. I do not think that there has ever been any question about its efficiency; it is its resourcing that has been the problem. Even in the dark days of Tory government, the national health service's output per unit of resource was remarkable. If one compares the NHS with, for example, the privatised system in America, where they spend twice the proportion of gross domestic product on health but millions of their people do not have proper health care, one sees that the NHS is remarkable but has been under-resourced for many decades.
	Some Budgets ago, the Chancellor decided to announce massive increases in spending on health. At that time, France spent 3 per cent. more of its GDP on health than us. Three per cent. of GDP is roughly £50 million per constituency every single year. Let us imagine the effect of that sum of money over a 30-year period. At that time, I said that I wanted the £50 million in my constituency every year, and we are moving in that direction, which is welcome. The Germans spend even more than the French, and it is not surprising that those countries had better health outcomes than ours simply because they were better resourced. As I say, however, we are moving in the right direction.
	I congratulate the Chancellor on his renewed emphasis on public borrowing for investment; he is absolutely right. United Kingdom gross public borrowing levels are very low by international and historical standards, and there is scope for substantial increases in public investment based on public borrowing. Low long-term interest rates reflect low inflationary expectations, so there is no problem there—public investment is in fact very cheap.
	By contrast, our infrastructure needs are great. The Budget shows that the overall quality of our infrastructure compares badly with that in France and Germany. We must invest heavily in infrastructure for the long term, and we should do so through public borrowing. Private borrowing for investment is expensive, and the Exchequer pays a high premium for private investment, which is one reason why I congratulate my right hon. Friend on his emphasis on public investment in this Budget. If we examine the railways, for example, we see that there has been a shift from public to private investment and that the cost of renewing track is four times greater than it was 10 years ago, which is scandalous. That shows how efficient public investment is and how private investment has almost become corrupt.
	I welcome the Chancellor's contrasting the performance of the British economy with that of the eurozone. This year, the forecast for growth in the eurozone is 1.7 per cent., which is not enough to sustain employment levels, and one can expect unemployment to rise still further in the eurozone countries. The forecast for growth in Britain is between 3 and 3.5 per cent. That is an enormous difference between Britain and the eurozone.
	I shall quote from the Chancellor's speech, although it is not strictly in context. He referred to
	"the flexibility to take the right monetary and fiscal decisions at the right time to sustain stability and growth".—[Official Report, 17 March 2004; Vol. 419, c. 324.]
	That sounds like a good old Keynesian view—managing the economy by choosing monetary and fiscal policies to suit current needs. That is not possible in the eurozone, and it is not surprising that eurozone countries struggle to deal with serious unemployment and low growth. If I were the German Finance Minister, I would want to be able to reduce interest rates, induce a little currency depreciation and relax fiscal policy to boost the economy. Eurozone countries cannot do that because they are tied into economic and monetary union, which is a millstone around their necks. I congratulate the Chancellor on his renewed commitment to what appears to be a Keynesian, demand-management approach to economics, which is sensible. I also congratulate him on keeping Britain out of the euro for the past seven years. I hope that he will continue doing that good job and keep the euro where it belongs—in the very long grass.
	I have some concerns about the Chancellor's speech, particularly about cuts in civil service jobs. We need more employment rather than less in some areas of the civil service, and particularly in the immigration service. Many of my constituents come to my surgeries with immigration problems. I have certainly not seen evidence of overstaffing in the immigration service; indeed, I have seen the reverse. We have new tax credit schemes that take a lot of administration, so perhaps we need more rather than fewer staff at the Inland Revenue, but I stand to be corrected.
	I visited the VAT inspectorate some time ago. It seems that each new VAT inspector can collect six times their salary in tax, and that Inland Revenue inspectors can collect eight times their own salary in tax. More tax inspectors would produce far more money for the Treasury than the cost of their salaries, so there is a case for more rather than fewer tax inspectors. A report published this week states that some 15.7 per cent. of VAT is not collected, and that that figure has increased. That is the equivalent of £12 billion a year, which is a lot of money that the Chancellor could well do with to spend on public services. We also need more benefits officers, because my constituents have problems with the processing of their benefits claims. I am worried about cuts in civil service jobs—no doubt the civil service can become more efficient in certain areas, but I would not want cuts in the services that I have mentioned.
	I want to finish by referring to health—this afternoon's debate is essentially about health—and in particular alcohol and taxation. A report published two weeks ago by the Academy of Medical Sciences drew attention to the link between price and alcohol consumption. Over the past 30 years, the cost of alcohol as a proportion of income has fallen by about one half. The Academy of Medical Sciences suggests that a small increase—even a 10 per cent. increase—in the real cost of alcoholic drinks could have enormously beneficial effects. A 10 per cent. increase in price would reduce deaths from cirrhosis of the liver by 5 per cent. in men and 7.1 per cent. in women. It would also lower murder rates and reduce alcohol-related deaths by 28.8 per cent. for men and 37.4 per cent. for women. Those figures are astonishing, and they were obtained by research by the Academy of Medical Sciences. We have a national alcohol problem that must be addressed; we cannot ignore prices or run away from the reality that we must raise them for the consumer to reduce dangerous alcohol consumption.
	We should also reduce duty-free allowances and increase the policing of our borders to reduce alcohol smuggling. There is much to be said for restricting the sale of alcohol to the young. I would even suggest minimum retail prices in supermarkets. Pubs and clubs suffer from competition from the cheap alcohol available in supermarkets, and I can see nothing wrong with a health-based minimum price for alcohol in retail outlets, in which case I am sure that we would have better national health, less violent crime, lower death rates, reduced costs to the NHS and would begin to deal with the binge drinking problem.

Robert Walter: I am interested in the theory that the hon. Gentleman is expounding, but I wonder whether he will remind the House of what happened in the tobacco market when duties were increased. At one stage, 90 per cent. of the hand-rolled tobacco in this country was illegally imported because duty was so high.

Kelvin Hopkins: I take the hon. Gentleman's point, but tobacco is small and easy to smuggle. We must rigorously police tobacco imports, but I appreciate that it is difficult. Alcohol is larger than tobacco and easier to detect. There is a difference, and it would be easier to control the smuggling of alcohol than tobacco.
	Alcohol imposes enormous costs on the NHS, and it also imposes a policing cost. Every Saturday night in my town, the police are on the streets dealing with young people who have obviously abused alcohol. Social services must deal with children from families where alcohol abuse has led to domestic violence.

Paul Burstow: Has the hon. Gentleman considered that it might be worth examining the fact that policing costs do not fall on those who provide alcohol in pubs? Perhaps those costs should be returned to those who provide alcohol and sell it to drunken people.

Kelvin Hopkins: I accept the hon. Gentleman's point, which the Home Secretary is considering. A simple increase in the price of alcohol and the maintenance of a minimum price for it would be effective, but we must take other measures. My proposal is not a complete alcohol strategy and relates to price only.
	Finally, the policy would bring the Chancellor enormous revenues that he could spend on public services to benefit the whole population. I am sure that the policy would be popular. A small number of people would, no doubt, complain about a 10 per cent. increase in the price of their drinks, but the great majority of the population would see the sense in raising prices to reduce the harmful level of alcohol abuse, which would lead to a much more civilised life for everybody. In particular, it would reduce the damage that is done to children by their parents' drinking. I urge my right hon. Friend the Chancellor and other Ministers seriously to consider raising the real price of alcohol through alcohol taxation.

Gillian Shephard: I am delighted to be called to speak in this Budget debate. I make no excuse for changing the subject to that of biofuels: that will be no surprise to the Economic Secretary. I am not deterred by the fact that we usefully debated biofuels 10 days ago, on 11 March. That debate, of which I should like to remind the House, allowed hon. Members on both sides to examine with remarkable unanimity the excellent report on biofuels by the Select Committee on Environment, Food and Rural Affairs, which was published last September. During the debate, the hon. Member for Southampton, Test (Dr. Whitehead) said that
	"to get the attention of the House for an idea, one has to enunciate it at least six times."—[Official Report, 11 March 2004; Vol. 418, c. 1731.]
	He went on to say that he had talked about a bioethanol escalator at least five times. I am aware that I am raising the issue of biofuels for at least the fifth or sixth time; I feel as though I am recycling in person.
	The debate on 11 March illustrates the fact that although there is no problem in gaining the attention of the House on this subject, there seems to be a problem—perhaps rather less so since the Budget—in gaining that of the Government. In that debate, the Minister for the Environment said:
	"I can honestly say that I have attended few debates during which the case has been made so persuasively, and Members have spoken with such authority . . . All their contributions made a great deal of sense".
	He went on to point out—albeit to an audience of Members who had demonstrated that they needed no persuasion—that substitution of biofuels for fossil fuels would save millions of tonnes of carbon per year, and he added:
	"The question is: how can the Government support this process?"—[Official Report, 11 March 2004; Vol. 418, c. 1743–45.]
	At that moment—I am so glad that he is here—the Economic Secretary entered the Chamber, and there was a frisson of excitement as hon. Members allowed themselves to wonder for a moment whether an announcement was imminent—but no, he had come in to walk the Consolidated Fund (No. 2) Bill, and no pronouncement followed. Perhaps we will have one today.
	As the Minister for the Environment said on 11 March, there is enthusiasm and support from both sides of this House, from the other place, and from a huge range of organisations on the need for more Government help for the development of biofuels. Bioethanol and biodiesel offer proven environmental benefits compared with petrol, because they provide air quality benefits, security of fuel supply, and alternative markets for UK agricultural producers.
	Over the past year, the House has seen several well supported early-day motions, a number of debates and a unanimous report from the Select Committee. The Government can be in no doubt about the size of the political lobby in favour of more support for biofuels. Ministers, especially the Economic Secretary, have received many delegations. Nationally, there is strong support from the CBI, major manufacturers, Friends of the Earth, British Chambers of Commerce, the agriculture industry and many others. Until the Budget announcement last week, the collective view was that although the duty reduction of 20p per litre announced in last year's Budget was very welcome, it was not enough to stimulate further development of the industry. One witness to the Select Committee described biofuels manufacture in the UK as
	"an extremely small cottage industry",
	and on 11 March the hon. Member for Sherwood (Paddy Tipping) described it, rather unflatteringly, as "some chip oil recycling".
	The debate on 11 March—it was timely, because it took place before the Budget—revealed enthusiasm and support not only for our cause, but for a variety of solutions to the problem. The Chairman of the Select Committee, my right hon. Friend the Member for Fylde (Mr. Jack), pointed out that in order for the Government to follow EU guidelines targeting 2 per cent. biodiesel by 2005, there would need to be an 80-fold expansion of production, to 32 million litres per month, compared with current production of 400,000 litres per month. He drew the House's attention to an amendment to the Energy Bill tabled in the other place, which would
	"'require all producers selling road transport fuel in the United Kingdom to show that over the course of a calendar year a specified proportion of such fuel was biofuel.'"—[Official Report, 11 March 2004; Vol. 418, c. 1718.]
	He added that such a requirement would be without cost to the Government. The hon. Member for Sherwood supported that proposal and suggested that the Government might consider a further duty derogation and capital grants and allowances. The hon. Member for Southampton, Test spoke of an ethanol escalator, which he has advocated with great knowledge on several occasions.
	The Government are not short of support or suggestions on the way forward—nor, indeed, of obligations into which they entered on their own account. Their own policy commission on food and farming recommended in the Curry report that
	"the Government should reduce duty on biofuels to that charged on other clean fuels."
	The Government have committed themselves by introducing the 20p per litre fuel duty reduction that was announced in the previous Budget. They signed up to the requirements of the EU biofuels directive, which will require the UK to notify to the EU Commission by 1 July this year the volume of biofuel that will be used in the UK by the end of 2005—in other words, those decisions will have to be made within the next four months. The Government's own energy White Paper, which was produced a year ago, gave a commitment to produce
	"an assessment of the overall energy implications of both a hydrogen economy and of large scale biomass based fuels, and to develop road maps of the possible transition to these new fuels and vehicles."
	In the light of all that, what does the Budget offer? The 20p per litre duty incentive in favour of biodiesel will be maintained until at least 2007; the same incentive for bioethanol, which was announced last year, will be introduced from 1 January 2005, again with the differential guaranteed until at least 2007; the Government will undertake consultation over the summer to examine in detail the implications of input-based taxation for biofuels; and there will be discussion on the applications of capital allowances to support investment in the most environmentally beneficial biofuels processing plants, with a view to announcing the outcome in the 2004 pre-Budget report.
	Those moves are positive in that they announce stability of duty levels for a given period and point to further consideration of the issue—as well as to further delay, of course. However, I am bound to say to the Economic Secretary that the Budget disappointed people in the field. Global Commodities UK Ltd., which is based in Dereham in Norfolk, says that the Government have failed to listen. The company had been hoping to boost the county's agricultural economy by using rapeseed oil for fuel production, but told the Eastern Daily Press on 18 March:
	"The Germans have just cut tax on their biofuels to zero. It is just not a level playing field. Farmers in Europe are growing rape seed to produce fuel but ours can't."
	British Sugar, which was planning to create a £55 million bioethanol plant at Wissington in my constituency, said:
	"Many European governments have already put fiscal support measures in place that are proving sufficient to encourage the development of large-scale industries. Regrettably the level of support announced by the Chancellor today is insufficient to create a similar situation in the UK."
	So where do we go from here? The Economic Secretary has said that he has been impressed by the coherence and force of the lobbying for more action to help biofuels. He should know, because he has received, with great courtesy, many delegations and lobby groups on the matter. However, in the House of Commons and the other place, there is perhaps a need to provide a stronger focus at parliamentary level. I am therefore delighted that the hon. Members for Sherwood, for Nottingham, South (Alan Simpson) and for South-East Cornwall (Mr. Breed), all of whom knew that I intended to raise the matter this afternoon, agreed to join me in forming an informal, all-party pressure group to provide such a focus. The Economic Secretary will be hearing more from us.
	Earlier, I referred to the variety of approaches that the Government might adopt in encouraging biofuel production. Let me draw hon. Members' attention to another, extremely imaginative approach that was presented as an entry to the East of England Development Agency's Landmark competition, which is now reaching its final stages. The project, which is called Star of the East, is backed by the university of East Anglia in partnership with Powergen. It has attracted wide, cross-party support in Norfolk and Norwich. It proposes a renewables power station, based on a derelict site in Norwich, with a major research and development component, which will burn biomass, develop new ways of processing biofeedstocks and have a biofuels facility. If the Star of the East wins the East of England Development Agency Landmark competition, the Government will get high-level research, a renewables power station, genuine encouragement for biofuels, an outlet for agricultural produce and a world-class site. I shall happily send the details to the Economic Secretary.
	I have given the Treasury spokesman rather a battering this afternoon, but the Budget affects all aspects of our lives. Many hon. Members have concentrated on health. Biofuels could affect the health of the nation and, indeed, the international community. We have to reduce carbon emissions and be responsible, for the sake of this generation and the next. If the Government gave more encouragement to the production of biofuels, they could congratulate themselves on their initiative. I hope that they will consider increased encouragement in future.

Linda Gilroy: It is a pleasure to follow the right hon. Member for South-West Norfolk (Mrs. Shephard) and to have heard her interesting contribution to the debate. It will be of interest to people in Devon and Cornwall, where biofuels offer new diversification potential in farming crops.
	I welcome the opportunity to make a contribution to the debate on health. Successive Budgets since 1997 have provided sound public finances and the basis for significant increases in resources for all our public services. They have enabled us to tackle the significant under-investment of previous decades, which was perhaps most apparent in the health service.
	During the 1997 election campaign, it seemed as though people on every doorstep related a difficult story about employment. My constituency has experienced some of the most dramatic falls in unemployment in the country. I remember when my right hon. Friend the Member for Darlington (Mr. Milburn), who made an interesting contribution to the debate, visited my constituency in 1996. We discussed the way in which solving unemployment could contribute significantly to reducing poverty and the attendant stress and ill health. We have made progress on employment.
	In the 2001 election campaign, however, when I knocked on some 4,000 doors, I was struck by the fact that we still had much to do for the health service, even though we had put in place important building blocks on which to base the investment that was announced in the Budget that followed the election. I want to consider what the investment is achieving and what it will and can achieve. I also want to discuss the Government's commitment to spend money, which is matched by their commitment to efficiency. I stress to my hon. Friends on the Front Bench that that is matched by the commitment of our local health authority, primary care trust and acute hospital trust to ensuring that we get value for money. I want to make one or two points, of which my hon. Friend the Minister may be able to take note to help us to do exactly that.
	First, I want to consider the scale of investment as it affects Plymouth and what has happened since 1997. Funding for the former South and West Devon health authority increased from £367 million to approximately £500 million. That is a significant investment, which will set us on course for the 10-year plan to double health investment. Successive Budgets provide for that and dedicate so much more money to our health service than in the past.
	Primary care trust funding for Plymouth will increase from £230 million to approximately £272 million between 2003–04 and 2005–06. We will get a new diagnostic and treatment centre, the Vanguard project, which is funded with £129 million of private finance initiative money. We have a £39 million extension to the south-west cardiothoracic centre at Derriford hospital. In an intervention on my right hon. Friend the Secretary of State, I mentioned that that enabled us to increase the number of cardio-patients from 700 in the mid-1990s to 1,850 this year.
	I will answer the rhetorical question that I posed. Previously, people were referred to Bristol and Brompton, and the unit was built on the premise that some 500 people would be treated locally. We continue to send some 500 people to Bristol and Brompton but we are now treating 1,300 people. I suspect that many of them would have suffered an early death through the previous lack of investment in our health service.
	In the primary care trust that now covers the former South and West Devon health authority area, the number of people who wait more than 13 weeks for out-patient treatment has decreased by a substantial 66 per cent. since 1997. That is one indicator of good value for money. Primary care trusts spend 75 per cent. of the money for the health service, thus enabling doctors to be our champions. That is accompanied by the radical new way in which hospital funding operates. The hon. Member for Sutton and Cheam (Mr. Burstow) referred to that method of payment by results. I make a plea to my hon. Friend the Minister to examine the way in which we might refine the tariff systems that are being introduced.
	The system has teething problems, which especially affect high cost, low volume services such as those that specialist hospitals like Derriford provide. For example, a cardiac bypass operation has the same hospital reference group and therefore the same tariff as a quadruple bypass operation. Such a system is likely to result in Plymouth hospitals trust losing more than £1 million in cardiothoracics alone, owing to distorting effects in the case mix. My hon. Friend knows that we, like many southern hospital trusts, have an accumulated deficit in hospital funding. I hope that we have the opportunity to discuss that with her before the system is fully rolled out.
	Other aspects need to be considered. For example, pay represents 65 per cent. of hospital costs. Derriford has an effective pay review programme to identify savings and ensure that the money is concentrated on front-line services. For example, it runs a locum bank to try to achieve some cost savings. However, the market forces factor that applies to the hospital reference group increases or reduces the tariff. Plymouth hospitals trust has had its tariff reduced by 7 per cent. from the average. Consequently, St. Mary's NHS trust in London, which has the highest market forces factor, will earn 42 per cent. more per patient than Plymouth hospitals trust for performing the same procedure. That cannot merely represent the differences in the cost factors that operate—undoubtedly, things are more expensive in London, but not by that amount. In 2000–01, Plymouth hospitals trust undertook a piece of work that revealed that the average cost per employee was £27,000. If we make a comparison with other trusts that have similar costs per employee, we find that East London and The City Mental Health NHS Trust has a 30 per cent. higher staff market forces factor than that trust, yet London weighting would amount to no more than a difference of 11 per cent. I therefore hope, as the hon. Member for Sutton and Cheam argued, that we will examine that before it is rolled out much further.
	The primary care trust is also working hard to deliver our community and mental health services in Plymouth. Against the background of considerable challenges, I am pleased that it achieved a two-star rating in the first such exercise this year. Those challenges arise from the health inequalities that have grown up over several decades. As a result of the doubtful legacy of my Conservative predecessor, I represent the poorest ward in England on the 1995 index of local conditions. Our primary care trust must meet challenges such that a man living in inner-city Plymouth, which I represent, will die 10 years earlier than his counterpart living in the leafy suburbs, which are covered by the same primary care trust.
	The trust is committed to meeting those changes, and has some innovative programmes. For instance, it has one of the most successful smoking cessation programmes in the country at present. Were my right hon. Friend the Secretary of State for Health present, I would have congratulated him on his efforts to take part in his own smoking cessation programme and invited him, as I have done on two occasions already this evening, to visit Plymouth to see the good work being done in that respect. Another programme with which we have had particular success, and which in years to come—although it is not possible to see the immediate payback—will help to reduce social inequalities, is the work to reduce teenage pregnancy, which, of course, is often accompanied by single parenthood and the sort of poverty that leads to a vicious cycle of ill health, unemployment and other problems.
	Our primary care trust has also worked hard with the acute hospital to reduce the prescribing budget, without, of course, reducing the quality of prescribing practice to patients. That has been particularly successful, and it has been able to save seven-figure sums by entering into partnership with consultants in the acute hospital to try to get the prescribing regime right for those in hospital. Therefore when they come out of hospital, the PCT is able to ensure that their medication can continue in a value-for-money way.
	The trust has been so successful in doing this that I was caught in a double bind earlier this year when I was approached by constituents, Mr. and Mrs. Tomes, on behalf of their son, Ashleigh. In that regard, my right hon. Friend the Secretary of State mentioned in his opening speech the great advances that will come as a result of new gene therapies. Some of those are already on-stream, and some of them address rare diseases, so the medicines being developed are therefore required in small numbers, and their developmental costs are very high. If, as in the case of my constituents and those of some 39 other Members of the House, 40 people in the country can benefit from a particular therapy, the cost of developing it and then delivering it will be very high. Recently, I went with an all-party group and members of the Society of Multipolysaccharide Diseases to discuss with the Minister of State some of the issues in relation to prescribing for such rare diseases, and we were much impressed by his grasp of the human issues associated with parents knowing that a drug is available. In this case, the drug can range in cost between £80,000 and £140,000 per prescription per year, and more and more such drugs will come on-stream. That will be an additional challenge to already hard-pressed primary care trust budgets. We will work with the Minister of State, who is seized of the challenge that faces us in the future.
	The Red Book refers to the 10-year framework for science and innovation. I welcome the announcement that the key focus of the Government's commitment to science will be to ensure that clinical research plays its full part in generating health and economic benefits, and that that will be matched by the increase in national health service funding for research and development.
	This Government have made serious inroads into the health challenges, with serious money and serious investment. They are serious about delivering a framework to deliver good health outcomes from that investment, and about making sure that there are enough health care staff, with good terms and conditions. Labour Members will know that that has come about by choice not chance, and if choice not chance informs the next election, this and successive Budgets will give the British people confidence to deliver the strong and stable economy that will allow our public services, which are so important to them, to continue to develop.

Alistair Burt: It is a pleasure to follow the hon. Member for Plymouth, Sutton (Linda Gilroy), who made a skilful defence of the Budget in relation to the health needs of her constituents. I hope to match her eloquence, but I will not necessarily agree with all her arguments.
	It was quiet in Biggleswade last week. The still waters of the River Ivel were disturbed more by the gathering winds and gales that swept across the country at the weekend than by anything that the Chancellor said. That was not a great surprise—my constituents do not expect all that much from this Chancellor, and they were not disappointed. They recognised, as we all do, in all parts of the House, that it was a highly political Budget, of which my constituents were not the targets. It was a speech all about the Chancellor, and his targets were sitting all around him, rather than across the Chamber or among my constituents.
	The Budget included serious political gestures; let me pick out two—one good, and one less good. I am sure that mine is not the only constituency to have a significant number of historic, old churches and, given that, we welcome very much the removal of VAT on church repairs. It will make a difference, and will recognise the position of churches in local communities. Whether or not that is related to their churchgoing and Christian communities, those churches are symbols of what is good and great in our communities. Full marks to the Chancellor for that.
	As a political gesture, the council tax bribe was crass and will be ineffective. The whole point of a bribe is that one is not supposed to see it coming or to know that it is there. The more obvious it is, the less effect it has. My constituents are not fools. My pensioner constituents well understand that their council tax bills have been rising in recent years at the Chancellor's behest. They have seen money taken away from their county council as it has been shifted from rural areas to other areas. They have seen extra responsibilities put on the county council, which have not been paid for. To compound that by effectively taking money from their neighbours and children to pay for what the Chancellor has asked leaves a very sour taste. They will not be fooled—it is like a magician explaining to everyone what the trick is, doing the trick, and then expecting applause for the suspension of disbelief that he has just dispelled. The Chancellor gets no marks for such a crass political gesture.
	Before I say something about health, let me touch on two themes that are increasingly becoming a hallmark of the present Chancellor, and are perpetuated by the Budget. Notwithstanding all the things that are working well and are encouraging in today's UK economy—and how grateful the Chancellor must continually be to my right hon. and learned Friend the Member for Rushcliffe (Mr. Clarke) and my right hon. Friend John Major for the economic legacy that they left him—the Chancellor is steadily taking risks and undermining the very basis of the things of which he can boast so grandly at the Dispatch Box.
	I am indebted for an excellent speech last Wednesday by my right hon. Friend the Member for Hitchin and Harpenden (Mr. Lilley), who patiently explained the cumulative and long-term beneficial effects of Conservative reforms on trade unions, taxation, the competitiveness of the economy, the regulatory framework and the nationalised industries. He explained that it would take time for those effects to show in the economy. The flip side, as he also explained, is the damage being done by failure to understand the impact of those changes. A move away from their beneficial effects is inevitable, but it too would take time to feed through.
	We are already seeing some signs. There is an obvious decline in the UK's competitiveness, which is recognised throughout the world. There is also the growing voice of business and industry, which observe the damage being done. Nothing in the Budget speech suggested to me that the Chancellor understood the danger of throwing away what he was throwing away. Truly, in the words of Miss Joni Mitchell, you don't know what you've got till it's gone.
	The second theme that the Chancellor is increasingly in danger of failing to understand is his inability to restrain his two impulses, towards spending and towards being in complete control. Spending we know all about: it is easy to spend. Whether it does any good, and whether it does the good that it is designed to do, we have already discussed today in relation to health, and we will continue to do so. As for the control issue, the determination to control was illustrated in the Budget by two gestures, one very significant and one throwaway.
	The significant gesture was the casually offered snub to the Prime Minister when the Chancellor made it clear that it was he who would decide whether the Government opted to join the euro—a point picked up earlier by the hon. Member for Luton, North (Mr. Hopkins) when he welcomed "the Chancellor's decision" not to join. I did not think it was the Chancellor's decision to make—someone will correct me if I am wrong—but the Chancellor, of course, makes clear that it is.
	The throwaway gesture was the Chancellor's statement that he accepted a recommendation in Kate Barker's report on housing, published that morning, without much consideration and with no consultation. The report recommended that in the regions there should be one body responsible for housing and planning—no doubt under significant Whitehall control. So there it is: goodbye local democracy. Goodbye to those who understand the importance of greater development in their area, not at regional level but at local level, to the local communities and authorities that must deal with the consequences.
	It is consequences that I want to discuss now. One of the consequences of increasing large-scale development will involve local health services. Bedfordshire will have to accept 54,000 new houses in the next 17 years. Let me give the House an idea of the scale. The two biggest towns in my constituency are Sandy and Biggleswade, which between them have a little under 30,000 inhabitants. It has taken them hundreds of years to reach that size. In less than 17 years, new developments twice that size will come into being.
	In such cases, there is always an immediate pressure on health. Services lag behind development. My county is now irrevocably committed to years of catch-up. Bedford primary care trust already has a shortfall of some £19 million, and it was clear from the latest Government figures, released before Christmas, that there were no plans to close the gap in the next 20 years. Now there will be that further development. The proposal to take planning decisions further away from local communities and towards regional bodies, which the Chancellor so casually recommended, is scarcely good news for my constituents or those who plan health matters.
	It is not just about money. The Government, and the Secretary of State this afternoon, have made it clear that as far as they are concerned the major indicator in all issues related to health and public services is how much is spent—not how good a system is, how efficient it is, how welcome it is in a particular area or how understanding it is of that area's needs. Not all problems are solved in terms of how much is spent. Let me give two examples.
	First, there is the question of how the money is spent. Where in the Budget debate did we sense any confidence in the new GPs' contract and its effects, to which the Secretary of State did not refer? On 1 April, the new contract will come into force. What assurances have been given to primary care trusts, which are taking over its administration, that they will be able to provide a better out-of-hours service for their patients than GPs have been providing?
	We already know that the PCTs have been given a certain amount of money with which to handle the contract. We know how much the GPs were charged by those running out-of-hours services, and how much they intend to charge the PCTs; and we know that the two do not balance. What will happen? Here was an opportunity, just two weeks before the introduction of the new contract, to give PCTs some reassurance about what would happen should the money run out. There was no such reassurance. It is not a question of how much is there; it is a question of how it is used, and how it can be ensured that those responsible for services know what is to be done.
	The second problem is how to deal with the fact that more and more doctors and nurses are leaving the system. The system can have all the money it requires, but if it is not recruiting or retaining doctors and is losing nurses, it will not be able to deliver the services that it wants to deliver. Six months ago, the magazine Hospital Doctor published the results of a survey that indicated that up to three quarters of all hospital doctors intended to retire early. They cited stress, increased work load, declining clinical autonomy and a lack of support from management as key factors.
	Many of the issues are structural. They can be related to an overbearing, over-prescriptive regime in which targets and quotas have played their part. Do the Chancellor and the Government not see that putting money into an inadequately reformed system does nothing to alter those problems? All that happens is that raised expectations are followed by frustration and disappointment as doctors still feel unable to carry out their duties. They leave a poorer service, and patients lose faith as a result. I detected no understanding of that in the Budget debate and the Chancellor's remarks.
	Two weeks ago, the New Statesman reporter Glenda Cooper dealt with the issue of nurses in the NHS. She wrote
	"the NHS still needs to find 35,000 more nurses during the next five years—while at the same time a quarter of the workforce is due to retire, and up to one in five nurses drops out before the end of training."
	She referred to a recent MORI poll which found that one in 10 nurses planned to leave the profession in the next two years, chiefly because of not money but the inadequate shift pattern and the work that they were expected to do. She reported:
	"Nursing, they say, has become divorced from caring, sisters have been reduced to ward managers, and degrees and diplomas have become more important than bedpans and bedside manners."
	That is nothing to do with the money that goes into the health service; it is all to do with understanding the health service, and making the reforms that are needed to retain those valuable personnel. For all the talk and, I am afraid, all the Secretary of State's bluster today, I sensed no understanding of needs of that kind, or of the importance of retaining key people who make decisions.
	Let me end with a short plea. As I said earlier, I welcomed the concession on VAT related to church repairs. Will those at the Treasury have a word with the Minister of State, Department of Health, the right hon. Member for Barrow and Furness (Mr. Hutton) about the charging of VAT on capital projects for the NHS? Where public appeals have been launched to support them, might there be any relief of VAT required for building works resulting from such appeals?
	Recently, the Primrose appeal in Bedfordshire raised more than £2 million to support a new cancer unit at Bedford hospital. Donors throughout Bedfordshire were surprised and disappointed to learn that a concession given to the Macmillan charity, enabling the VAT that it would have to pay to be recovered through an internal mechanism in the health service, would not be available for the bulk of the money raised for the building itself.
	My hon. Friend the Member for Mid-Bedfordshire (Mr. Sayeed) and the hon. Member for Bedford (Mr. Hall) have visited the right hon. Member for Barrow and Furness, and I think that we have a ready ear there. We may be able to find a local solution to our particular problem, but I ask the right hon. Gentleman to investigate whether, where public appeals have been made on behalf of capital projects that will benefit the NHS, there is a way of ensuring that VAT that would otherwise be chargeable is spent on patient care, so that people raise money for treatment, not tax.
	The NHS is a great service, to which I am personally very strongly committed. My father worked all his life as a GP in the health service. My brother is a consultant anaesthetist and neither my wife nor I or any of our children have any private medical insurance. We are members of and wholly dependent on the NHS. Where the Budget has been singularly lacking in terms of response from the Government has been in understanding that money is not the answer, and in the determination of the Secretary of State to continue with partisan and rather tedious arguments and discussion of what we might do. It is not what the debate on the current NHS is all about, and I have offered some examples for consideration. I am perfectly confident that when my hon. Friend the Member for South Cambridgeshire (Mr. Lansley) replies from the Opposition Front Bench today and when he and our colleagues have the opportunity to run the service themselves, the public will finally get not only the Budget debates that they deserve but the NHS care that they have paid for, deserve and are entitled to expect.

George Young: It is a pleasure to follow the high-quality speech of my hon. Friend the Member for North-East Bedfordshire (Alistair Burt), who focused on the health service but began with some comments about broader issues in the Budget. It is quite difficult to explain to a 69-year-old who may have modest income and modest capital that they will get none of the Chancellor's munificence, whereas a 70-year-old who may be infinitely better off will get the £100. That bribe, as my hon. Friend called it, says something about the Chancellor. For seven years, he introduced complicated, focused, targeted means-tested benefits. Now, at the end of the seven years, he has cast that aside and is bringing in a universal benefit. That seems to say something about the failure of his strategy. He introduced those highly complicated schemes and is now moving from that towards universalism.
	I welcome the increase in resources being devoted to the NHS. The Secretary of State said when he opened the debate that we still have a long way to go, which is indeed the case. I got a fax last week from the Southampton University Hospitals NHS Trust about a constituent waiting for a scan appointment at the Wessex neurological centre. I quote what it said:
	"The waiting list for such an examination currently runs at around 52 weeks."
	The constituent in question had already been waiting for a scan for over a year. At a time when we are all being told that early detection leading to early treatment dramatically increases the prospects of recovery and survival, long waits of 52 weeks after a referral for examination are simply unacceptable.
	I know what the Minister is likely to say in response—that extra resources have been allocated, and that it takes time to procure the scanners and to train the staff. I want to look at the claim on resources. This year, there has been a 9 per cent. increase in cash resources for the NHS in Hampshire. With inflation at around 2 per cent., people might think that that left a healthy margin for real terms growth, but they would be wrong because 7.8 per cent. of the 9 per cent. is accounted for by what in health-speak is called "tariff growth."
	Tariff growth is the unavoidable increase in existing costs before one thinks about new commitments. It covers the national insurance increase, the reduction in doctors' hours, wage increases, the increased costs of drugs and so on. In other words, real growth is about 1.2 per cent. However, most of the trusts in Hampshire are running at a deficit. The cumulative total of deficits in Hampshire is £20 million. The trusts have been told to use the growth money to address the deficit and that £20 million is about 1 per cent. of the budget, which almost equates to the growth money.
	Also, in Hampshire many trusts have survived by transferring capital to revenue in order to balance the books, but that practice will no longer be possible because the Government have stopped it. That will exaggerate the underlying imbalance between revenue and expenditure. Therefore, in effect, there is precious little growth in Hampshire and consultation is about to start on difficult measures to balance the books.
	That leads me to a point that I have made before in these debates about the way in which money is distributed. My constituents get less per capita for health than anywhere else in the country—we are now 21 per cent. under the national average, and it was about 16 per cent. when this Government came to office. Therefore, although the totality of NHS resources is increasing, we are getting a reduced percentage of the total available.
	Of course, I accept the argument that resources need to be allocated according to need, and that there are parts of England with more severe health challenges than those that face us in Hampshire. What I do not accept, and what I have never seen justified, is that we can get by with £79 as opposed to £100—the average in England. There are wards of deprivation in Andover. Even people on above average incomes get ill. Indeed, health spend is often linked to longevity. Some of the costs in Hampshire are higher than elsewhere. For example, we spend more on agency nurses because of the difficulty of recruiting full-time nurses in a high-cost housing area such as Hampshire. If the funding we received was 85 per cent. of the national average as opposed to 79 per cent., we could probably cope. I urge the Government to revisit the distribution formula and to abandon the unjustified discrimination against the south-east, which we have seen not just in health but in the revenue support grant.
	To echo what my hon. Friend the Member for North-East Bedfordshire said about what the Secretary of State did not mention, a lot of reforms are taking place in the NHS at the moment and the right hon. Gentleman did not touch on any of them. An entirely new national programme for IT is coursing through the NHS. He did not mention the new GP contracts and the new out-of-hours service, which in my constituency looks as though it will mean that people will no longer be able to go to Andover hospital after 11 pm. They will either have to call out a GP or go to Winchester. We have the new contracts, the working-time directive and we are moving towards the national tariff and payment by results under the reforms to NHS financial flows. None of those was touched on by the Secretary of State but they are all vital matters that the NHS is addressing at the moment.
	Nor did the Secretary of State say one word about foundation trusts. We know that it is a sensitive subject for the Labour party but that is an issue that many of those who work in the NHS are now addressing. With foundation trusts, the Government are confronted with a dilemma entirely of their own making. They have said that all the capital borrowing by those trusts from the City will score as public expenditure, and will have to come out of the NHS Brown envelope. Therefore, the more successful the foundation trusts are in using that freedom to borrow, the greater the penalty the rest of the hospitals will have to pay in having their capital reduced to accommodate that growth. The NHS under Labour is like a hostage ingeniously tied up by his captors. The more he struggles to release the ropes around his hands, the tighter the noose around his neck.
	I have two possible "wave 1a" trusts in my constituency, and the one-off grant of £175,000 in no way covers the transitional costs, many of which will recur. How much will they be able to borrow? In a letter to me dated 11 March, the Minister of State told me:
	"The Independent Regulator sets the prudential borrowing limit for each NHS Foundation Trust on the basis of a prudential borrowing code . . . If you have further questions about the code, you may wish to contact the Regulator".
	So the fortunes of the trusts and, dare I say it, of the Government are now in the regulator's hands. What view will he take of the trusts in my constituency that are well run, but that have an excess of expenditure over income for the reasons that I have touched on? The regulator may well say that, because of the accumulated deficit, the imbalance on the revenue account and the backlog of maintenance, the ability to fund debt is very low. They may end up getting less money out of the new system than they would have received, had they remained under the NHS. That would be a severe blow for the Government's health policy.
	The message from the regulator is rather stark. I was reading NHS Magazine yesterday. Bill Moyes, the regulator, was quoted as saying:
	"Convince us you can cope as independent entities."
	He makes it clear that his function is about managing risk, not performance. He asks:
	"Are applicants financially strong enough? Are they financially stable?"
	Well, towards the end of the year, the Government may have some difficult questions to answer if many of the applicant trusts find that they are worse off under the new regime than they would have been under the old one.

Andrew Lansley: My right hon. Friend and I have discussed this matter, but it may be of interest to him—if not to Health Ministers, who are not present—that I have looked at a "wave 1" trust's service development strategy and it is not entirely in the hands of the independent regulator. That trust, at least, anticipates that nearly £50 million of its depreciation charge—its revaluation reserve on its balance sheet—will be replaced by public dividend capital. Of course, as that involves equity, rather than debt, it may increase its borrowing ratio, but a lot of hospitals elsewhere in the NHS might wonder where that money will come from on the Government's balance sheet.

George Young: My hon. Friend makes a good point, and if I were a Health Minister approaching a general election, possibly 12 months away, I would be deeply worried about ending up with egg on my face because of that new policy, under which the trusts that have been encouraged to apply for foundation status may find that they are worse off.
	In passing, I mention the senseless cap on private patient income for foundation trusts. Hospitals in my constituency could increase their income and spend more money on treating NHS patients if it were not for the cap on the percentage of the income that they can generate from private patients—a cap that was not there for the first seven years of the Labour Government. The Government managed perfectly well without that cap until now, but they are now introducing that wholly unnecessary restraint on the ability of NHS hospitals to raise money for NHS patients.
	I want to end with a final word about a subject that has been raised twice at Prime Minister's questions. I have visited and kept in regular contact with a national charity, the Macular Disease Society, as it is based in my constituency. It is a membership society for people with age-related macular degeneration. Ministers will be well aware of the anxiety about the delay in introducing the treatment, photodynamic therapy, for wet age-related macular degeneration. Up to 7,500 new cases of that aggressive condition occur each year, and patients can go from seeing well to severe sight damage in three months.
	The Macular Disease Society is in close touch with patients, who are still being asked to pay £2,000 a time for up to six treatments, and consultants, whose primary care trusts tell them that they are not yet funded to give the treatment on the NHS. Ministers know that some 50 clinics in the country are currently capable of delivering the treatment, yet Ministers insist that training and staffing issues, not cost, are delaying implementation. The truth is that strategic health authorities and PCTs have been given the freedom to delay paying for treatment up to the end of June, and those who have not made provision in their budgets are doing just that. The result is that patients either have to find £2,000 per treatment, to be carried out by the same NHS consultant, or they start to lose their sight. Consultants across the country can deliver the treatment, but they have been refused the funding.
	In many letters to Members of Parliament, Ministers have said:
	"We will do all we can to ensure that services which have the ability to expand sooner than the nine month period do so and that new services come on stream as soon as they are able."
	When he winds up, I should like the Economic Secretary to tell us exactly what those Ministers have done. The treatment was approved in September last year by the National Institute for Clinical Excellence and the Department of Health, but Ministers still have not given direct orders to SHAs and PCTs to start delivering it through existing clinics and treatment centres.
	Although more than 100 patients a week are diagnosed and will be treated in the well-managed hospitals that offer the treatment, others will be invited to pay £2,000 for their first treatment or they will lose their sight and suffer appalling distress. We have made many demands of the Government during the debate, but it would be helpful if the Economic Secretary could say that, between now and June, the Government will take the necessary steps to ensure that the people who have that disease will get the treatment that they need, without having to pay £2,000.

Robert Walter: The Secretary of State for Health opened the debate with his endless good news story, but some of my constituents would treat his remarks with incredulity. When I first became a Member of Parliament in 1997, I could proudly say that my constituency came top of all lists in respect of health. We had the shortest waiting lists and the shortest waiting times, and so on. There was anecdotal evidence of people moving to Dorset to get treatments that were paid for there—I think of in vitro fertilisation treatment, for example. In those days, I received few complaints from constituents about treatment under the national health service, and those that I did receive were dealt with promptly, with treatment usually almost instantaneous. I am afraid that the story today is very different.
	Several of my hon. Friends have referred to out-of-hours services. The chairman and chief executive of the primary care trust in my constituency explained to me the other day how the new out-of-hours contract was envisaged for patients in Dorset. No longer would patients concerned about a child at home with a temperature of 104° at 10 o'clock at night be able to call their general practitioner in the knowledge that he would come around within a hour or so, be somewhat reassuring and deal with the problem.
	Now, people will have initially to call NHS Direct. They will then be redirected to a call centre in Dorset where a nurse will speak to them. The nurse will assess the problem and, if necessary, will suggest that the patient should visit a treatment centre, which could be anything up to 40 miles away from where they live. If the patient thinks the problem is serious and says, "I'd really like to see a doctor", the nurse is likely to say, "If it is that serious, we will call an ambulance for you." No longer will doctors be available to visit patients out of hours anywhere in the county of Dorset. When I suggested that that was a serious deterioration in service, I received the reply, "Of course, people have been abusing the service." Well, so be it: that is just one example.
	A month ago, a gentleman who had been diagnosed with prostate cancer visited my surgery. The PCT had funded a visit to a specialist centre at the Royal Surrey county hospital, which is some distance away, and he had to make his arrangements to get there. The specialist recommended a certain treatment for my constituent's prostate cancer, and he went home, expecting to be sent details of an appointment for it. Instead, he got a phone call from his doctor, saying that North Dorset PCT would not pay for it. I took up the case with the PCT and got the same answer.
	Lo and behold, another man with the same condition came to my surgery last week having been through the same cruel exercise. He had been sent to a centre of excellence for prostate cancer treatment and a treatment was recommended, but his PCT would not provide the money for it. When we told the PCT that a number of patients in Dorset had received the treatment, it said that the first patient had been given it by mistake because the hospital had not realised that the PCT would not pay. In the case of the second patient, we were told, "Ah yes, but he was under a different PCT in Dorset." If that is not postcode prescribing, I do not know what is.
	This morning—to add insult to injury—I received an e-mail from a lady whose family has a record of cancer. She said that she wanted a mammogram so that she could be reassured, but the PCT will not pay for one because she is 64 years old, so she will pay for one herself simply to get that reassurance. If that is what the Secretary of State calls equality of access, it has a very hollow ring to it.
	I should also like to take a more global view of the Budget. I listened to the Chancellor and read the Red Book, and it was interesting to compare what they said with what appeared in the report on the British economy produced only this month by the International Monetary Fund. I have somewhat greater confidence in the IMF's assessment of the British economy than in the Chancellor's, and its executive board assessment of the UK said:
	"Directors, however, noted that the buoyancy of domestic consumption has also been fuelled by robust increases in house prices and household debt, which has increased uncertainty on future developments . . . Directors stressed that the possibility of a hard landing in house prices and consumption cannot be ruled out particularly given uncertainties about the distribution of household assets and liabilities. To minimize these risks, prudent macroeconomic policies are needed . . . Noting the widening of the fiscal deficit . . . over the last three years, Directors concurred that the fiscal deficit needs to decline in the period ahead in order to observe the fiscal rules, strengthen fiscal fundamentals, and support monetary policy during the cyclical upswing. However, many Directors recommended a somewhat larger decline in the fiscal deficit in the medium term than that projected in the November pre-budget report."
	That assessment was written before last week's Budget statement. In order to achieve fiscal balance, the directors believe that fiscal policy and private investment in the future
	"should be more consistent with long-term fiscal requirements."
	The assessment continues:
	"Directors in general called for moderating the growth of spending in areas where current plans involve sharp increases, because this would limit . . . inefficiencies. . . . they recommended that the authorities"—
	that is the Treasury—
	"take further measures to ensure that increased spending is delivering value for money."
	The assessment adds:
	"In contrast, staff"—
	IMF staff—
	"saw the deficit declining only modestly over the medium term without new measures, to 2¾ per cent. of GDP, some 1 percentage point above the authorities' projections. Thus, additional measures were likely to be needed. In particular, staff saw a case for moderating the government's ambitious spending plans, as a more gradual increase in public spending would reduce the risks of inefficiencies."
	The staff believe
	"the case for fiscal adjustment, and specifically for revising the government's ambitious spending plans, was strengthened by the risk that the latter could involve significant inefficiencies . . . .the evidence that increased spending was bearing commensurate fruits was still scarce".
	That point has also been stressed in the most recent report on the United Kingdom from the Organisation for Economic Co-operation and Development. With staff views like that, I am not surprised that the Chancellor excluded himself from consideration as the next managing director of the IMF.
	I want also to concentrate on overall public spending and the consequent borrowing. The main focus of this year's Budget was public spending and, in particular, the announcement of the Government's overall spending target for the next comprehensive spending review, covering the period to 2007–08. In real terms, total managed expenditure is set to rise by 4 per cent. in the next financial year and by an average of 3¼ per cent. over the following three years. As a result, the share of public spending in GDP terms is projected to increase to 41.9 per cent. in 2005. The allocation of that extra public spending will be settled in the summer comprehensive spending review.
	The Treasury's projections suggest that that increase in spending is consistent with the Chancellor's famous golden rule, which says that, across the economic cycle, the Government will borrow only to finance investment. According to the Chancellor, the current Budget deficit is forecast to halve over the next year and to return to balance by 2006–07, with increasing surpluses expected thereafter. The Treasury, however, has already increased its forecast for overall public sector net borrowing in 2004–05 to £33 billion from the £31 billion in the pre-Budget report and the £24 billion in last year's Budget. Let us consider the Treasury's record; we should not forget its forecasts for the current year. The figure was £10 billion in the Budget of 2001, and it went up to £15 billion in the pre-Budget report of that year. In the 2002 Budget, the figure was £13 billion; in the pre-Budget report of 2002, it was £24 billion; in the Budget of 2003, it was £27 billion; in the pre-Budget report of 2003, it was £37.4 billion; and, in this Budget, the figure has reached £37.5 billion. That is above the Maastricht limit with which the Chancellor has proudly boasted compliance in the past. It is almost four times what he said it would be at the last election.
	When considered by independent forecasters such as the ITEM Club, it is clear that the outlook is little changed in subsequent years, with net borrowing projected to decline to only £31 billion in 2005–06, £27 billion in 2006–07 and £23 billion by 2008–09. In its view, the Chancellor's borrowing projections remain over-optimistic. He continues to expect a very strong rebound in tax revenues—nearly 8 per cent. in each of the next two years and well ahead of economic growth in subsequent years.
	The Government also assume substantial increases in the tax take, particularly from income tax, corporation tax and, to use their words, "other taxes and royalties". Nevertheless, the assumptions of revenue buoyancy continue to appear to me and to most forecasters as too optimistic. They imply a large rise in effective tax rates, which seems implausible in the absence of increases in actual tax rates, which we know will not happen before the election.
	The Treasury's detailed forecasts show receipts from income tax and social security contributions rising by 7.3 per cent. in 2004–05. That is well ahead of the likely increase in household income. According to the Treasury, corporation tax receipts are forecast to increase by more than 21 per cent.—about twice as fast as company profits. The ITEM Club's forecasts suggest that overall Government revenues will be about £4 billion below Treasury projections in 2004–05, implying public sector net borrowing of £37 billion. The forecasts expect a revenue shortfall of £7 billion compared with Treasury projections in 2005–06, with net borrowing of £38 billion. That would mean that, even on his definition, the Chancellor would break his golden rule in 2005–06.
	The National Institute of Economic and Social Research says that
	"most people would assess whether the Golden Rule has been met by adding up current surpluses and deficits in each year of the cycle in question".
	However, the Government do not do it that way; they have their own way of looking at it. They have presented no justification for the approach that they adopt. As the institute says, they have
	"merely asserted that it has always done this. Obviously an error is not corrected simply by being of long-standing".
	In conclusion, the Government are projected to borrow £37.5 billion this year, and nearly £155 billion over the following five years. All independent commentators say that that is too optimistic. I know that the strategy will be aided by the £15 billion in savings identified by the Government's efficiency expert, Peter Gershon, but the only other way to look at the issue is through further rises in taxes. The Budget confirms that the Chancellor wants further rises in taxes—there have been 60 since he became Chancellor—but that there will not be any further rises in tax rates until after the general election. Without prosperity, the Government will not be able to deliver without increasing taxation after the next election.

Crispin Blunt: It is always a pleasure to follow my hon. Friend the Member for North Dorset (Mr. Walter), who gave us an elegant explanation of why the Chancellor's curriculum vitae has remained firmly in London rather than being dispatched to Washington. I hope later to pick up on the wider economic themes that he outlined.
	First, however, I want to pick up the debate's health theme. I listened to the remarks of my right hon. Friend the Member for North-West Hampshire (Sir George Young) on expenditure in Hampshire. I want to lay claim to his speech and say simply, "Delete Hampshire; insert Surrey." The situation is precisely the same in Surrey, which is why there is a crisis in the public service provision of education and health in Surrey, given the relative expenditure in the south-east.
	As I listened to the Secretary of State produce his litany of figures on the numbers of doctors and nurses, it seemed like a flashback to the 1980s when I watched the then Prime Minister—I watched from outside the Chamber—at Question Time reciting statistics in exactly the same fashion about how the health service was improving. Of course, it was improving then, because there was a real increase in health expenditure throughout the time of the Conservative Government. However, a remark made by the hon. Member for Luton, North (Mr. Hopkins) was especially important. He said that the output per unit of resource was quite remarkable during those years. The Conservative party's focus on reform in the health service ensured that the output per unit of resource was sustained throughout its period of government.
	If the Government wonder why they have such a trifling increase in output per unit of resource despite throwing such an enormous amount at the health service, perhaps I can give one small explanation by citing an example that a junior doctor in my local hospital gave me. He pointed out that the Government claim that there are 10,000 more doctors than there were in 1997, of whom 5,000 are junior doctors. However, one should examine the number of hours for which those doctors work. Their hours have reduced from 72 hours a week in 1997 to 56 now. When the Government calculate the increased number of doctors, they calculate the number of whole-time equivalents on the basis of doctors working 40 hours a week. If we use the Government's methods to calculate whole-time equivalents by considering hours worked on the ground, we find that there are perhaps 1,447 fewer doctors in terms of hours worked. That explains why output has failed to keep up with the resources devoted. Of course, the figures calculated by the junior doctor are based on an assumption about the reduction in the number of hours worked by doctors, but it makes a fairly convincing case for why the Government face enormous difficulties in achieving a rise in output that will begin to measure up to the resources provided to the health service.
	It was a huge treat to hear the eloquent testament of the former Secretary of State, the right hon. Member for Darlington (Mr. Milburn), to the property-owning democracy. A friend of mine, Mr. Peter Scrope, was the right hon. Gentleman's opponent in Darlington in 1997, and he would have enjoyed the philosophical journey that the right hon. Gentleman has undertaken over the past six or seven years.

David Ruffley: A bit late.

Crispin Blunt: Better late than never. The right hon. Gentleman's eloquent testament to the need for reform and a property-owning democracy was extremely welcome, even though it came from the other side of the House.
	I would have been more impressed by the statistics cited by the Secretary of State, and, indeed, the case presented by the right hon. Member for Darlington when he was Secretary of State, if the figures had not been subject to the most shocking manipulation. Targets themselves manipulate. They manipulate the behaviour of the health service as clinicians' priorities become secondary to the political priority of delivering targets.
	Of course, the measurement of achievement of those targets is manipulated. We are all aware of waiting lists for waiting lists and of the redefinition of parts of accident and emergency departments as observation wards so that it can be claimed that people have been moved out of those departments. A deeply unhappy story from my constituency shows political manipulation in the health service through the amalgamation of Crawley and East Surrey hospitals into a single trust. Simply disgraceful decisions were made to serve political interests in the marginal Labour seat of Crawley. I have made this case many times, and I shall continue to remind the Government of it. The exercise not only put patients in the area served by the trust in danger by twisting clinical priorities to fit the political necessities of the hon. Member for Crawley (Laura Moffatt), but had a financial cost: some £50,000 a month of health money was taken away from the people of the United Kingdom because the subsidy to pay for the exercise came directly from the Department of Health. Additionally, there was a £200,000 study to investigate the possibility of building a new hospital at Pease Pottage, although it found that that would be economically impossible unless one wanted to bankrupt the entire health economy in east Surrey and north-west Sussex.
	The right hon. Member for Darlington was correct about the Budget's political astuteness. In many ways, it did virtually nothing, and I suppose Conservative Members should be grateful when a Labour Chancellor does virtually nothing because that is usually much better than his doing anything at all. However, my hon. Friend the Member for North-East Bedfordshire (Alistair Burt) pointed out the totally non-Budget elements of the Budget—the acceptance of the Barker report and the appalling proposal that planning should take place at regional level. That represents a total demolition of local democracy because it will avoid responsibility being exercised by people on the ground who are closest to where planning decisions should be taken. They will not be able to decide, in the interests of people whom they represent, whether they want a liberal or restrictive planning process.
	My hon. Friend the Member for North-East Bedfordshire referred to the excellent speech on Wednesday by our right hon. Friend the Member for Hitchin and Harpenden (Mr. Lilley). He talked about the length of the economic fuse in the hands of any Chancellor. The Chancellor claims credit for the current performance of the economy, but one should examine the trends that he inherited in 1997. Growth had been sustained since 1992–93 and the fiscal position was improving extremely rapidly. Inflation had been tamed—we had delivered inflation of 2.5 per cent. in 1997—and unemployment was falling so fast that it made a complete mockery of Labour's policy to deal with youth unemployment. Its election manifesto contained a target of dealing with 250,000 young unemployed people, but by the time it got into office, 167,000 of them had already found work. We had a 10 per cent. savings rate, and our future pension provision for the people of the United Kingdom was the envy of the rest of Europe. We also had a high position in the competitiveness league in the developed world. The Chancellor received a golden economic inheritance that was built on work done in the economy, which to a degree had started in 1976 when the International Monetary Fund began to dictate economic policy to the previous Labour Government.
	The Chancellor has gambled successfully on his growth forecasts over the past year or two. His growth forecast last year turned out to be a successful gamble. His Budget presents us with a growth forecast for the next two years of 3.25 per cent., which is well above the trend. Nearly 20 years ago, when I was stationed in Germany with the Army, I spent some of my quieter evenings at the casino in Bad Oeynhausen indulging in a little gambling. A friend and I had a little system. We went around the roulette tables to find a trend, which we would bet against. For an uncomfortably long time, we kept leaving the casino with more money than we went in with. Eventually, the probability of that trend continuing meant that we went back where we started.
	My point is that trends end. To rely on a presentation of economic growth of 3.25 per cent. for the next two years and 2.75 per cent. for 2006 is a pretty serious gamble against an underlying position that has wholly changed since 1997. Public expenditure is set to rise by £120 million a year by 2007–08. Private debt has risen by 93 per cent. to nearly £1,000 billion since 1997. The private savings rate collapsed from 10 per cent. down to a lowly 3.3 per cent. a couple of years ago. It is now at 5 per cent. Our pension provision is worsening rapidly from the position inherited in 1997, when the UK was the second largest relative investor in countries as remotely connected to the UK as Mexico. That investment happened because there was an enormous amount of money, managed by the City of London, that would provide for the future pensions of the people of the UK.
	On the television programme "If . . . The Generations Fall Out", to be shown, I think, on Wednesday, people speculate that our future pensioners will not be properly provided for and there will be a huge battle between their interests and those of the working population. That was simply not the case in 1997. The Chancellor has presided over a huge missed opportunity.
	The scale of private debt and public debt is accelerating. The simple fact is that those trends are not sustainable. There will have to be a reckoning, which will come at the cost of economic growth. We will need a much tighter fiscal policy, which will mean tax rises and, quite probably, expenditure cuts from the plans presented in the Budget.

Mark Hoban: I note that I am the fifth consecutive Opposition Member to speak. I wonder why so few Labour Members are prepared to defend their record in a health debate.
	I want to deal with three aspects of the Budget as they affect my constituents. The theme is clear: we should never underestimate the impact of Budget speeches on individual lives. A sweeping gesture by the Chancellor in the Chamber might generate favourable headlines on Budget day, but it could have a long-standing, negative impact on our constituents' lives.
	The first aspect has its origins in the 2002 Budget, when the Chancellor announced a zero-rate ban for corporation tax. Ministers told us that that was to stimulate enterprise. It was based on the false, and perhaps naive, assumption that only limited companies were entrepreneurial. We know, however, that partnerships, sole traders and other unincorporated businesses are also entrepreneurial. Many commentators explained that the measure would encourage unincorporated businesses to incorporate to reduce their tax bill—many hon. Members also made that point. Indeed, I explained the problem both on the Floor of the House during the Budget debate and in the Finance Bill Committee.
	The Paymaster General recognised what would happen, and I am grateful to Taxation for unearthing a quote from the debate in the 2002 Finance Bill Committee, in which she said:
	"the underlying issue is whether the Government have struck the right balance between incentives to incorporate and to remain unincorporated . . . Surely small businesses will not look a gift horse in the mouth."—[Official Report, Standing Committee F, 16 May 2002; c. 116.]
	Indeed, they did not. What was predicted at the time transpired. A flood of businesses wanted to incorporate to benefit from the lower tax bills that incorporation brought. It was the right thing to do. Who would pass up the opportunity to reduce a tax bill in such a straightforward way, particularly when invited to do so by the Paymaster General?
	However, the increase in the number of incorporations led to the announcement last week of a 19 per cent. tax rate on profits distributed by small companies to minimise the tax benefit that owners of limited companies had, compared with those whose income from their businesses was liable to income tax. It was one of the Chancellor's six stealth taxes announced last Wednesday, taking the total from 60 to 66. It was obvious that that would happen. We knew that business would take advantage of that to reduce the tax bill and, as the Paymaster General said, no small business would look that gift horse in the mouth.
	The Government should pay heed to a lesson: changes in the tax system have a behavioural impact. A tax system that is biased towards a particular type of economic activity or organisation will encourage people to move in that direction. The Government should not be surprised if that bias in the system is exploited by people taking advantage of it. Indeed, the further the tax system moves away from a neutral view on a type of economic activity or organisation, the more likely it is that businesses will take the opportunity to exploit that loophole and subvert the Government's objective. Indeed, how can businesses plan for the future if the Government can change their mind within two years about something as fundamental and important to business as changing the nature of taxation for small businesses?
	The second aspect of the Budget that I want to touch on is the Lyons report on relocating civil servants out of London and the south-east. The Chancellor said that
	"the Government are accepting and will implement the Lyons Review for the relocation of civil service jobs. We will relocate out of Whitehall a total of 20,000 public sector jobs, creating new opportunities in the regions and nations of the United Kingdom."—[Official Report, 17 March 2004; Vol. 419, c. 328.]
	The core of the Lyons report focuses on the additional costs incurred by Departments of being in London and the benefits of dispersal to the regions that gain the jobs. Tucked away towards the back of the report, in appendix A on page 101, is the suggestion that nearly 1,000 jobs in my constituency should be transferred to Wales. Those are jobs at the Office for National Statistics in Titchfield. I have to confess that I had not realised that Titchfield was part of Whitehall, as the Chancellor sees it. Clearly, there is a poor grasp of geography in the Treasury.
	I accept that we need to make savings in the running costs of government—my right hon. Friend the shadow Chancellor has made that case so persuasively that even the Chancellor has tried to catch up—but I wonder whether the Minister can tell me the likely cost savings of the move. As I said, the Lyons report was clear about the cost of locating Departments in London, but it was less robust on the costs of locating them in the south-east. If we add to that the circumstances of the individual department of the ONS—the national pay rates for its employees and the lack of a supplement for working in Hampshire—it seems that there would be no cost savings to be gained from transferring employees from Titchfield to Wales. Indeed, the ONS owns the building in Titchfield, so no rental costs will be saved by moving the employees and that department to Wales.
	It is hard to see what cost savings will be brought about by relocation. Has an assessment been made of the impact of such moves on the local economy? The Lyons report states:
	"Dispersal of government jobs is likely to have positive effects for regional economies with direct spending for departments and their employees creating jobs in addition to those relocated . . . this additional impact ranged from neutral to one extra new job for every two moved."
	If that is the case for regions gaining jobs, surely the reverse is true for those regions losing jobs. What assessment has the ONS made of the impact of a move to Wales on the 1,200 to 1,300 employees at Titchfield and what are their chances of finding alternative jobs in the area? Many of those who work in Titchfield are working mothers, for whom the prospect of moving to Wales may not be practical. There are a number of employees whose family arrangements are tied up with living in the area. I understand that no assessment has been made of the number of people who are prepared or able to move out of the area.
	One reason that the ONS is such a popular employer in my constituency is the flexibility it allows to those who have particular care obligations to their families, whether that concerns an elderly relative or children. The Government's aim is to encourage more women to work, and to encourage more single mothers to find work to support their family, but moving that department away from Titchfield is likely significantly to affect many of my constituents who work for it. The Chancellor seemed very proud to be shifting those jobs to the regions and nations of Britain, and he welcomed the move in his Budget speech, but do not let him think that what he proposed is welcome in every household in our regions and nations.
	I turn finally to a point that my hon. Friends the Members for Reigate (Mr. Blunt) and for North-East Bedfordshire (Alistair Burt) made about the Barker report, published on the same day as the Budget. The report was significant; it announced that between 70,000 and 120,000 houses should be built to tackle supply-side problems in the housing market. That is another aspect of the Budget that sounds dramatic; it creates a sense of a Chancellor able to conjure up new houses, but it has consequences for my constituents. I want to see more people able to afford their own home, but the Barker report seems to be about moderating the real growth in house prices, slightly restricting that growth by building additional houses. That approach is unlikely to develop the affordable housing that people in my constituency need.
	My hon. Friends touched on some other, broader concerns. The Barker report recommended diluting the power that local councils can exercise over developments in their own area, by transferring more responsibility for planning to regional planning bodies. It states:
	"Regional Planning Bodies and Regional Housing Boards should be merged to create single bodies responsible for managing regional housing markets, delivering the region's affordability target".
	Miss Barker goes on to say:
	"Even in the absence of elected regional assemblies, a streamlined institutional framework is possible and desirable."
	If those proposals are accepted, the power of local authorities will be further diminished and the ways in which people in areas such as mine can hold their local councillors to account for planning decisions will be reduced.
	The report also talks about land value. It says:
	"Building on intensively farmed land would result in far smaller costs. These alternative land values are part of the framework within which the costs and benefits of housebuilding should be assessed."
	It proposed:
	"Moving towards an alternative approach, whereby land for development is assessed according to its relative value in society . . . including the implication that some Green Belt land should be re-designated."
	There is no green-belt land in Fareham or south-east Hampshire, but there is some remaining farmland. If the value of that is further reduced to encourage development and to skew the cost-benefit ratio in favour of more development, we shall see a continuous stretch of development from Southampton to Portsmouth along the M27, all to achieve the goal of moderating the growth in house prices in the south-east.
	Where is the infrastructure to support that additional housing? One of the biggest issues facing my constituents is the fact that the current infrastructure fails to meet the needs of the existing housing development in Fareham. Our schools, hospitals and roads are already threatened by planned development. Where will the resources come from to build new infrastructure? The main arterial routes in the area, the M27, A27 and A32, are already clogged with traffic. Only one NHS dentist in Fareham is accepting patients, and even he has a six-month waiting list. It is worth noting that when the Secretary of State for Health talked about increasing capacity throughout the health service, he did not mention dentistry.

Peter Luff: A cavity.

Mark Hoban: It was, as my hon. Friend says, a cavity in the Health Secretary's speech, but it causes people in my constituency a problem when they cannot find a dentist to meet their needs. The dentists with whom they are registered say that, because of the economics of dental practice, they can no longer accept NHS patients, so all patients are required to switch to private dental services. How much worse will those services become if more and more people are crowded into our area as a consequence of decisions by unaccountable and unelected regional planning and housing boards?
	There is little cheer for my constituents in this Budget. The Chancellor is meddling yet again in the tax affairs of small companies, reversing some of the effects of the Budget of just two years ago. Jobs in Titchfield are being moved around the country as if they were a pile of chips being shunted across a roulette table by a croupier. More houses are being imposed on an area that cannot cope with the additional building already going on.
	The Chancellor gives the impression that he thinks that the economy is like a machine: pull a lever, flick a switch here and open a valve there, and all will be well. He forgets at his peril that what he is playing with is not some theoretical model of the economy or a machine, but the lives of our constituents. He may welcome the headlines the day after the Budget, but the damage that he causes individuals and their families will last far longer than the glow of those headlines.

Paul Farrelly: I am delighted to follow the hon. Member for Fareham (Mr. Hoban), not to defend the Budget, but to proclaim it and the opportunities that if offers the NHS, not least in my constituency and industrial north Staffordshire as a whole.
	This is the eighth Budget under a Labour Government, though only the third that I, as a new Member, have had the pleasure of witnessing from these Benches. I remember, years ago, this time of year provoking pain, not pleasure—so much so that in the 1980s and early 1990s I used to go out of my way to stay out of the way, to avoid listening to news of tax cuts for the privileged few and yet more public service cuts affecting the neediest. Indeed, under 18 years of Conservative government, there was only one Budget that I can loosely associate with improving the health of the nation, or at least a tiny, precious part of it. That was when Nigel Lawson stuck 10p on the price of a packet of fags and my granddad, Tom King, a 40-plus-a-day man since he served in the trenches, said that he had had enough of those damned Tories, as he put it, and never lit up a cigarette again.
	What a difference we have seen in our NHS since 1997, the year that my granddad died. By 2007–08, spending on health care will be more than double what it was a decade ago. That is an achievement that I wish my granddad had lived to see. Let us be clear what that increased investment really means. It does not just mean massive figures plucked out of the air; it means, by 2008, 80,000 more nurses than in 1997, 25,000 more doctors and the biggest hospital-building programme ever. It means that the NHS is safe in Labour's hands.
	What of the Opposition? Have they learned the lessons of 1997 and 2001? They have certainly learned, from my right hon. Friend the Chancellor, to talk the talk—sticking, they say, to our plans for health for two years. However, when one puts those plans under a microscope, one finds that the reality is different. The shadow Secretary of State for Health, for example, says that he is committed to free access to health services, based on need and not on the ability to pay. How does he square that with his so-called "patients passports"? Those self-same patients passports will, to quote him,
	"allow them to take a proportion of the cost of NHS treatment to offset the cost of independent treatment, which can then be topped-up at the patient's own expense."
	How does that make for free and equal access to health care? I noticed that he could not, or would not, answer the Secretary of State's intervention earlier, and no wonder. He certainly has a health plan. It is a plan to give those who can already afford to go private an even bigger helping hand, and it is a pauper's plan for the rest of the population and the NHS.
	Under Labour, the NHS is certainly making progress; otherwise the Conservative party would not want to match our spending. Sadly, though, we have not yet found a cure for forgetfulness or the schizophrenic double-speak afflicting Opposition Front-Bench Members.

David Wilshire: If the hon. Gentleman is so certain that the NHS is safe in his Government's hands, can he tell me why the Government are ordering my local primary care trust to cut spending by £17 million next year?

Paul Farrelly: Clearly, I cannot speak about the financial management of the PCT in the hon. Gentleman's area, but I can speak about the bewilderment that most of the population feels about the Conservatives' fixation with vouchers—now called "passports".
	I shall speak about the successes and the continuing challenges in the NHS in north Staffordshire—an area with some of the worst and most complex health needs in the country. For decades, one of the biggest issues in our area has been hospital facilities that are housed on different sites in outdated, crumbling Victorian buildings. That is not good for patients or for staff, and it is certainly not good enough for the NHS in the 20th century, let alone the 21st. Patients who needed intensive care sometimes faced journeys of dozens of miles. The press labelled Stoke-on-Trent "the sick city". More than 20,000 people signed petitions crying out for a new hospital to replace the Victorian city general in Stoke-on-Trent and the North Staffordshire royal infirmary on a single site. They did not sign for patients passports, or visas, or vouchers; they signed for a new hospital on their doorstep, because if they or their families or friends were ill, they wanted to be treated as close to home as possible.
	If we are to give patients better treatment—to give them that choice—we need to invest in more and modern capacity on their doorstep, which is precisely what Labour is doing in north Staffordshire. Under the Labour Government, work has started on a brand-new £350 million acute hospital on the site of the city general. Gone will be the days when patients were shuttled back and forth on trolleys and in ambulances between the royal infirmary and the wards of the city general. In its place, there will be a super-hospital with a state-of-the-art diagnostic centre, an accident unit, new intermediate care beds and modern wards with the best of facilities for the modern age. That hospital is just one of 114 new hospital developments commissioned since 1997.
	Labour's ambitions in north Staffordshire do not stop there. As part of the £350 million project, there will be a brand-new community hospital on the crumbling Haywood and Stanfield sites in north Stoke. Before I entered Parliament in 2001, I chaired the north Staffordshire "Elderly Care for All" campaign, fighting for better elderly care locally. I remember only too vividly visiting experts describing those decaying hospitals as the worst that they had ever seen. Now, finally, after many years of flimsy promises, north Stoke is getting its own brand-new community hospital. In my constituency, Newcastle-under-Lyme, our local community hospital at Bradwell is expanding and developing to offer services such as minor surgery to people in the surrounding areas of Bradwell, Chesterton and Kidsgrove. Such services will complement those offered by acute hospitals and take the pressure off them.
	We are not stopping there. We want to invest in primary care—in more local health care on the doorstep—to make sure that there is less need for people to go into hospital at all. In Newcastle-under-Lyme alone, within the north Staffordshire NHS LIFT—local improvement finance trust—programme, work is forging ahead on a brand-new £3 million health centre in Cross Heath, which is among the most deprived 10 per cent. of wards in the country. A brand-new £2 million-plus health centre is planned for Audley, serving the former mining villages in that area. In Clayton, work has started on a £1 million extension of the Kingsbridge health centre, and in the town centre, among other developments, a brand-new GP surgery opened earlier this month. Those are not merely figures plucked out of the air—£1 million in the Budget delivered in London here, another £1 million there. They are real achievements, which my constituents notice and which will improve their lives.
	With our new primary care trust in Newcastle-under-Lyme, we are getting improvements just where we need them. I am always suspicious of continuous organisation change: often it is change for change's sake, or demoralising to NHS staff. However, in my constituency, I appreciate the closer working relationship with my local PCT than used to be possible with the old, more remote health authority. My local councillors appreciate that too. If the House will indulge me, as the first Labour speaker after several Opposition speakers, I shall name them: they include John and Gill Williams and Sylvia Butler in Cross Heath, and my good friend Eddie Boden, chairman of Staffordshire county council, who lives in Audley. Working with the PCT, they have played major roles in the improvements to primary care achieved as a result of the LIFT programme coming into their areas.
	Despite all those advances, not everything in the garden is rosy. More NHS dentists are needed in my locality, as they are across the country. In specialist services, to give just one example, we in Newcastle and north Staffordshire urgently need to tackle the lack of any proper provision for diagnosis and support for people affected by autism or Asperger's syndrome, starting with kids of pre-school age and continuing through to give schoolchildren and adults the support that they need.
	Across the board, we need to deliver all those better facilities, and more, because of the desperate health needs of the people of north Staffordshire. For years, the area depended on coal mining and pottery making—hard physical jobs, done in dirty, dusty and dangerous conditions. Given that the local diet was not the best, it is no wonder that under Labour the Potteries qualified for more investment as a health action zone. To deliver, we must attract and retain the extra doctors, nurses and consultants that Labour's policies and investment in the NHS are already generating. Too often in the past, north Staffordshire and other industrial areas have found it hard to fill vacancies, simply because in our area each job imposes greater demands on each professional than in wealthier, leafier areas.
	Under Labour, the investment to tackle health inequalities is being made—nowhere more so than in the new medical school at Keele university in Newcastle-under-Lyme, which was given the green light by my right hon. Friend the Member for Barrow and Furness (Mr. Hutton) shortly after he became a Minister of State at the Department of Health in 1999. He is to visit Chesterton in my constituency next month: he will always be welcome there, and I hope that he will find time to open our new town centre practice. Our first medical students are now training at Keele and what has proudly become the University hospital of North Staffordshire. By 2009, Keele medical school will be hosting its full complement of 610 medical students. It is therefore already playing its full part in training extra new doctors for the country as a whole, and local people hope that many will choose to stay in north Staffordshire and help us to overcome our historical difficulties of recruitment.
	Labour's investment in north Staffordshire's local NHS, which the Budget continues, is playing a vital role in a much bigger vision of the regeneration of the area as a whole. As well as playing host to a new medical school, Keele university is developing a science park, attracting businesses involved in medical technology and building what is known in the trade as a medical cluster. It is now the home of cutting-edge biotechnology firms such as Biocomposites—a company that develops synthetic devices for tissue regeneration. I was delighted to play a small part in its decision to relocate to Keele, rather than go to Florida or elsewhere overseas.
	The new hospital and other health and regeneration initiatives such as housing market renewal provide opportunities to exploit and develop construction skills. Our regional development agency, Advantage West Midlands, has just backed a new construction skills centre of excellence in north Staffordshire. In the context of regeneration, we are looking closely at the Chancellor's plans to relocate Government agencies to the regions. Envious eyes are being cast over the National Institute for Clinical Excellence and health and safety bodies.
	In our local NHS, we can continue to implement 21st-century health care only with the sort of investment that was confirmed by the Chancellor last week: a 7 per cent.-plus real-terms increase in resources each year to 2008. Patients want that investment. They do not want passports, visas or vouchers; they want investment in our NHS—investment that makes our NHS safe and that we can only trust a Labour Government to make.

David Ruffley: The Chancellor wanted this to be viewed as a political Budget, setting the battleground for the next general election. I welcome that view of the Budget, because it gives the Conservatives the opportunity to fight on our own ground, where the Chancellor of the Exchequer is naturally far weaker.
	I say that for three reasons. First, the Chancellor does not have a reputation for being an efficient and proficient tackler of waste; nor is he good at delivering efficiency savings. For seven years he has been telling the country how wisely and prudently he has been spending public money. In his comprehensive spending reviews in 1998, 2000 and 2002, he invited us to believe that extra money would be tied to greater efficiency. He invited us to believe also that through his public service agreement system, Departments that delivered on targets would be rewarded and that Departments that did not succeed in hitting targets would be penalised. None of that ever happened; it was for the birds. Instead, there has been a 50 per cent. increase in the cost of running central Government Departments since the Chancellor came to office. That amounts to spending about £7 billion extra and meant last year that an additional 511 civil servants were employed every week. After seven years, and after all the fiddling and target setting, the Chancellor has announced that there will not be 130 PSAs. There will be fewer, and they will be measuring outcomes rather than outputs and inputs. He will be abolishing about 500 service delivery agreements.
	On top of all that, we are given more promises, pledges and talk in the Budget about how there will be a substantial decrease in bureaucracy. We are told that there will be more proportionate inspection, greater incentives for better performance, and more local autonomy and flexibility. My verdict is that we have heard it all before from the Chancellor, for every year for seven years. After seven years of no action but plenty of talk, why should the country believe that he will be any more effective in future?
	Conveniently, but I fear belatedly, Sir Peter Gershon has trotted along at the Chancellor's behest. He has told us that he can find efficiency savings of £20 billion a year by 2008. We are invited to believe that much of that can be done by getting rid of 40,000 civil servants—just for starters—in the Department for Work and Pensions and the Revenue and Excise departments. As most observers have said, that will probably account for £1.5 billion, so Sir Peter is a long way shy of the £20 billion that he noisily advertises.
	As The Economist pointed out this week, the reality is that deep structural reform is needed for the Chancellor and Sir Peter Gershon to get anywhere near savings of £20 billion by 2008. There is a need for deep structural reform that only the Conservative party is advocating and explaining in detail. Answer comes there none from the Labour Benches on serious reform in the health service and serious structural reform in the Department for Education and Skills.
	On efficiency savings and waste cutting, I like the way in which the Chancellor has come on to our ground. In principle, he has conceded that we have been right all along. However, he has done something more in his Budget by shooting himself in the political foot. He will never be able to say again between now and the next election that cutting waste means a cut in front-line services. That is an argument that he wanted to push against the official Opposition. He is now unable to do that because he has conceded, on his own logic, that efficiency savings mean that front-line services can be protected. That has been our argument all along.
	My second reason for arguing that there is a weakness in the Chancellor's political thinking, as expressed in the Budget, is that at the next election, the British public will be asking a basic question. They will want to know whether, for all the money that has been put into our important core public services, there has been a material improvement so that they can say, "Our local schools, hospitals, support services for pensioners and the local police force are better." I do not think that they will be able to answer that question in the affirmative.
	We have seen a 22 per cent. increase in truanting in our state education system. The decline in crime began in 1993 when my right hon. and learned Friend the Member for Folkestone and Hythe (Mr. Howard), who is now the Leader of the Opposition, became the Home Secretary. That decline stopped in 2001 and it is now plateauing. In certain parts of the crime figures—for example, violent crime—we have seen some of the greatest hikes for a long time. Gun crime has doubled since 1997. Overall, the law and order story is not a good one.
	Particular attention should be drawn to health. There should be more beds than administrators. When we left office in 1997, senior managers, administrators and estate staff numbered 196,700. In 2001, there were 224,030. That increase means that although the ratio of administrative staff to beds was 0:9 when the Conservative Government left office, it is now 1:1.
	What about waiting lists? Some of the longest waiting times have been reduced. The more telling figures about waiting times for all other operations—the mean and median waiting times—tell a story of NHS decline. During 1999 to 2000, the mean waiting time in days was 90. For 2000–03, it was 99. The median figure for those same two years was 43 and 49 respectively. Those statistics do not come from Conservative central office; they are not even from the National Audit Office. They come from the Department of Health hospital episodes statistics table 2 from 1999 to 2003.
	Probably most Members receive more mail about health than anything else. Despite the 37.5 per cent. increase in funding of the NHS, hospital activity based on finished consultant episodes—completed operations—has risen by only 4.8 per cent. The source of that figure is the Department of Health hospital episodes statistics from 1999 to 2002. Hospital admissions have increased by an average of only 1.9 per cent. annually from 1999 to 2002. Incidentally, that is less than the 2.9 per cent. annual increase from 1991 to 1999.
	The OECD has reinforced claims that extra NHS funding has not been spent as well as it should have been. It added:
	"Productivity seems to have declined as the growth in the number of doctors, nurses, hospital buildings and equipment have (not yet) been fully reflected in a growing numbers of treatments. In fact, growth in the volume of health care output has slowed down compared to the first half of the 1990s."
	That is because, as we have argued, the structures are not right and the Chancellor must take personal responsibility for the pace of radical health reform in the NHS. He has frustrated serious reform based on the foundation hospital model because, let us face it, he is pandering—that is the right word—to the Labour movement. He thinks that if he argues for a publicly funded health service with no additional private sector involvement—or as little as possible—he will curry favour with his client groups. He is responsible for slowing down the radical reform that the NHS desperately needs.
	Thirdly, the Budget has great political weaknesses because of its provisions on taxation. The Red Book confirms the Chancellor's tax addiction. By 2008 the tax burden will be 38.3 per cent.—the highest for just over 20 years. We have had 66 tax rises since the Chancellor took office, and the tax take under his chancellorship is up 50 per cent. in cash terms, which is equivalent to about £5,000 more tax per household since 1997. However, the British public should worry about the path of taxation, as he has indulged in a borrowing binge. His borrowing figures are four times higher than he predicted at the last election. The Institute for Fiscal Studies, the National Institute of Economic and Social Research and The Economist all predict that he will break his golden rule at the start of the next economic cycle which, conveniently, will occur in spring 2006, after the likely date of the election. They quantify the gap as at least £10 billion a year, and it must be plugged with either spending cuts or tax increases, or a mixture of the two. It is more likely that there will be £10 billion-worth of tax increases.
	During the last election campaign, the Chancellor was Trappist-like in his refusal to talk about his intentions on tax. After he won that election, however, he introduced hikes in national insurance, thus breaching his promise not to break the upper earnings limit. If the Chancellor of the Exchequer is confident in the Budget that his numbers add up, that he will not break the golden rule at the start of the next economic cycle in spring 2006 and that he will not have to raise taxes, the Financial Secretary and the Economic Secretary, who are in the Chamber tonight, will have no difficulty in giving the House and the country a guarantee that there will be no tax rises and that, because of the Budget judgment, there is no need to raise taxes next year or the year after. If they will not do so, the public and the press will be entitled to recall that the Chancellor has form—and previous. He goes to the electorate denying that he has any intention of putting up tax, but after the election does precisely that. When they have worked out that he has form—and previous—they will be entitled to conclude that a vote for Labour is indeed a vote for third-term tax increases.

Peter Luff: Ultimately, our debate on the Budget raises a fundamental question—who knows best how to spend our money, the Chancellor or the people, the taxpayer or the tax raiser? In their hearts, most people know the answer to that question. The Chancellor could do himself a great service by listening to the arguments that have been made. He started badly in the debate on Wednesday, as he ignored the two speeches that followed his statement, and chatted to his friend, the Prime Minister, on the Front Bench. He would have done well to listen to those speeches, because in their different ways they were important contributions. He should listen to independent commentators such as the ITEM Club, which today made confident predictions about the black hole and a third-term Labour tax rise, about which my hon. Friend the Member for Bury St. Edmunds (Mr. Ruffley) has rightly spoken. The British people believe that those third-term tax rises are inevitable, and the Chancellor should listen to them, as opinion polls show.
	The 2005 election, assuming that that is when it takes place, may be a bad one to win, because of the serious economic problems that the Chancellor of the Exchequer will leave his successor. He, of course, hopes that someone else will succeed him as Chancellor, as he hopes to be Prime Minister then. He hopes that he can blame the new Chancellor for problems of his creation. We have to be honest about the fact that the economy is doing fairly well at present—I do not think that anyone would argue against that. There are looming issues, such as the trade deficit and the appalling savings ratio, which have been mentioned throughout our debate. The truth, however, is that employment is pretty good and people are fairly comfortable. The Chancellor has achieved that with two good decisions and two pieces of good luck. The first of the two good decisions was independence for the Bank of England, which sent a powerful signal to the financial markets about his seriousness of purpose. The other decision, or rather non-decision, was not going into the single European currency—a wise course of action, and I hope that the Chancellor continues to prevail in the argument with the Prime Minister on that.
	The Chancellor has had a couple of bits of good luck, though. One relatively minor but nevertheless significant piece of good luck was the enormous revenues that came from the 3G licence sale, for example, which made a huge contribution to bringing down the national debt. The reduction in the national debt owes a lot to that bit of good luck that fell the Chancellor's way. The other piece of good luck is the one that Labour Members always snigger at when it is mentioned—the golden economic heritage that he had when he took over as Chancellor. [Interruption.] I think I heard a few mumbles of discontent from the Labour Benches.
	If one looks at the Red Book, as I have done in some detail, one does not have to be a statistician to look at the graph on page 21 showing the inflation statistics and to realise that inflation has been pretty stable since mid-1993, which is a good long time before the 1997 general election. Then there is the matter of growth. The Chancellor allowed himself a few jokes in his Budget speech on Wednesday. He rather wittily corrected himself and said that he had accidentally misled the House. The period of sustained growth was the longest not for 100 years, but for 200 years. He apologised for that omission. What he did not say is where that period began.
	The Red Book tells us on page 15
	"with GDP now having grown for 46 consecutive quarters".
	Let us count back the quarters. Four of them in 2003, four of them in 2002, four of them in 2001, four of them in 2000, four of them in 1999, four of them in 1998 and the first couple, ahead of the Labour party's victory in the 1997 election, in 1997. That makes 27 quarters under Labour's stewardship. Then, of course, there is one in 1997 for the Conservative Government, another four in 1996, four in 1995, four in 1994, four in 1993 and a couple in 1992, making 19 quarters on our watch. Yes, it is true that there have been 46 consecutive quarters of growth, but the credit for that belongs to previous Conservative Chancellors of the Exchequer.
	The present Chancellor's achievement is, for once, not to mess that up, and for that he deserves some limited congratulations. Although he may not be ruining it, there are some worrying signs. The success that he boasts about so confidently from the Dispatch Box is much more limited in reality. The truth is that if one throws money at a problem, some of it will stick and a bit of the problem will get better, but for the amount of money that is being thrown at the problems of this country, things have not got as much better as they ought to have got. And money has been thrown.
	There are guiding lines in the Red Book. On page 189, with reference to income tax, we are told:
	"The starting and basic rate limits are increased in line with statutory indexation and there are no changes to the income tax rates."
	That sounds tremendously reassuring, but table C8 on page 256 shows that over the period 2002–03 to 2004–05 income tax take by the Chancellor will have gone up by 13.5 per cent., social security contributions by 20.3 per cent., value added tax by 15 per cent., fuel duties by 10.5 per cent., council tax by 18 per cent. and total current receipts by nearly 15 per cent. He has taken a huge amount more of our money from us. Since he became Chancellor he has taken in excess of £1,500 more for every man, woman and child in the country. With that kind of extra money, he should be able to do a better job.
	The tragedy is—I am indebted to Ruth Lea in her excellent pamphlet, "The Price of the Profligate Chancellor", for drawing my attention to this—that the people who are paying the highest price for that are not the rich, nor those on middle incomes, but the poor. She draws my attention to a table derived from the work of the Office for National Statistics, which shows that while the percentage of gross income paid in tax is 35.6 per cent. on average, for the poorest quintile—the bottom 20 per cent—it is 42.1 per cent. Increased taxes hurt the poor. That is a message that the Chancellor needs to learn. He has certainly taxed them.
	We have seen a steady growth in taxation as a percentage of GDP, and we have seen the complete and abysmal failure of the Chancellor to predict his borrowing. We are told on page 3 of the Red Book at paragraph 1.13, and it is repeated verbatim at paragraph 2.38 because the Chancellor is so fond of this:
	"The estimated 2003–04 outturn for the public sector current budget shows a deficit of £21.3 billion compared with projected deficits of £19.3 billion and £8.4 billion in the 2003 Pre-Budget Report",
	and so on, with the Chancellor appearing to be quite confident about the relative increases in borrowing.
	Again, I am indebted to Ruth Lea for showing us the truth about those borrowing figures. Actually, the increase in the Chancellor's own predictions has been shameful. In the 2002 Budget, he said that public sector net borrowing for 2002 would be £11 billion, but we now learn that it worked out at £22.9 billion—an increase of £11.9 billion. For 2003, the figure has moved from £13 billion to £37.5 billion, so his error is £24.5 billion. For 2004, he has already increased his estimate from £13 billion to £33 billion—an increase of £20 billion. For 2005 and 2006, he is confidently predicting modest reductions in net borrowing. Let us see what happens, as the trend is far from encouraging.
	Let us turn to spending. On page 9 of the Red Book, we read:
	"The Government's strategy is to deliver improvements in public services through sustained investment and reform to ensure that taxpayers receive value for money."
	We are all in favour of taxpayers receiving value for money, but in an extremely unconvincing performance at the start of the debate, the Secretary of State for Health failed to answer the charge that that simply has not happened in the health sector. The only period for which I have figures is 1996 to 2001. In that period, the number of whole-time equivalents for managers in the national health service rose by 15.5 per cent., while the number of whole-time equivalents for nurses, midwives and health visiting staff rose by 7.3 per cent. In other words, the growth in managers was running at twice the rate of the growth in front-line health professionals. I think that that should worry the Government.
	The Chancellor is fond of talking about enormous gains in employment. If we look at the figures, we see that between September 2002 and September 2003, there was an increase of 153,000 people in the public sector and of 105,000 in construction. To be fair, much of that increase is coming from capital investment, but largely, although not exclusively, it is PFI investment that is again funded by the Chancellor. In fact, 258,000 of the jobs are public sector jobs, while the number of manufacturing jobs fell by 103,000 in one year.

Paul Farrelly: The hon. Gentleman is being very forensic, but perhaps he is being a touch forgetful. Will he explain to the House whether the 1987 stock market crash, the years of negative equity, withdrawal from the European exchange rate mechanism and the years of imprudently counting one-off privatisation proceeds as negative Government expenditure were, to pick up his theme, bad luck, accidents or acts of God? Or were they were simply bad policy by a previous Conservative Government?

Peter Luff: The hon. Gentleman leads me into a whole new speech that I would dearly like to make, destroying the analysis that he has just offered the House. In essence, the current Chancellor has faced relatively benign economic situations nationally by comparison with those faced by previous Chancellors. I know that the hon. Gentleman was not in the House at the time, but if he would care to remember some of the circumstances that the last Conservative Government faced, including the consequences of German reunification in particular, he would paint a very different picture. As for fiddling statistics, this Chancellor's treatment of issues such as PFI debt for the tube, and tax credits, which count as negative income tax, is fiddling statistics on a spectacular scale.

Paul Farrelly: rose—

Peter Luff: I shall happily give way a second time.

Paul Farrelly: If we indeed inherited a golden inheritance, to use the hon. Gentleman's own words, has he ever thought that after 1993, things simply could not have got any worse?

Peter Luff: That is the voice of a man who believes his own propaganda—something that I try very hard not to do. I shall happily take the hon. Gentleman to the bar after this debate, sit down and show him the economic series. The fact is that everything started getting better from 1993. Every economic series that one looks at shows that plain, simple and straightforward fact. It would do the House a great service if all Labour Members—I do not blame the hon. Gentleman in particular, as he is following a lead given him by people such as his Prime Minister and Chancellor—looked at the facts and saw what actually happened. If he did so, he would see just how wrong he was in his assertion and its implications.
	Before that intervention, I was discussing public sector employment and productivity. The previous speaker, my hon. Friend the Member for Bury St. Edmunds (Mr. Ruffley), gave us a fine analysis of productivity in the health sector, and again, the available statistics, which come from the Office for National Statistics publication on economic trends from July last year, only go up to 2001. Intriguingly, they show roughly no change in public sector productivity in 1996; a 1 per cent. improvement in 1997; and—those were years of austerity in public expenditure—another 1 per cent. improvement in 1998. As we get into the years in which the Chancellor increased spending, however, productivity fell by 2 per cent. in 1999; by 1 per cent. in 2000; and by 2 per cent. in 2001. It should surprise no one that if money is thrown at a system faster than the system can absorb it, the system will not spend it wisely.
	The Chancellor's Budget strategy raises some important questions. He is spending to the hilt and hoping to get away with it, and that is having some strange consequences at a local level in my constituency. I shall highlight the example of education spending—I unreservedly welcome the increased capital expenditure on schools in my constituency. On Friday last week, I opened a new classroom—the increased capital expenditure is clearly having a beneficial effect and I do not pretend that it is not.
	Revenue expenditure is sadly a big issue in Worcestershire, however. By increasing education expenditure in real terms, the Chancellor is bizarrely creating a worse problem for Worcestershire schools, which are falling behind their neighbours because of the rigged funding formula. Straight percentage increases in expenditure on schools means that Worcestershire schools will fall relatively further behind because of the iron law of compound interest. I urge Treasury Ministers to talk to their ministerial colleagues in the Office of the Deputy Prime Minister and say, "If we are putting extra money into schools, we must ensure that it is spent fairly across the country; otherwise anomalies between local education authorities will grow, with very serious consequences for the children in the local education authorities left behind."
	The Red Book—I do not know why it is called that because it is a white book—is the Chancellor's personal manifesto. Governments used to publish about one third of its contents; the other two thirds is public relations, spin and puff. The Chancellor talks glowingly about jobcentres on page 84 and about the role of primary care trusts in helping to address local need on page 150. I repeat my plea, which I have already made twice in this Chamber and intend to make again tomorrow at Health questions, for the Government to examine the consequences of not giving true independence to primary care trusts but running them from the centre, through strategic health authorities, while claiming that they are locally organised.
	That lack of independence has destroyed eight important health projects in south Worcestershire. One such project at Droitwich Spa in my constituency was intended to include a major new Jobcentre Plus, a police facility, a county council facility, a district council facility, a voluntary facility and a new health centre. Arbitrary changes to funding rules mean that we will not get that investment and that the whole project is at risk, which is completely contrary to the Red Book.
	We often hear Labour Members discussing our plans for Home Office expenditure, but I am not too impressed by the Government's plans for Home Office expenditure. Some 300 additional police officers are coming on stream this year in the West Mercia constabulary area, which is welcome. However, who has paid for them? Not the Home Secretary or the taxpayer nationally, but the council tax payer, through phenomenal increases in the police precept. The trouble is that those phenomenal increases are building huge resentment not against the Government—as they should do—but against the police. They lead people to ask, "Why am I not getting the police service I expect for the money that I am being forced to pay?" I urge Ministers to examine that question seriously. There have been 33 per cent. and 15 per cent. increases year on year, and the overall increase in the West Mercia constabulary's precept since the Government came to power is nine times the rate of inflation, which is simply unsustainable and creates problems for the management of the police.
	In a final footnote to my speech, I am disappointed to see the Chancellor's disclosure on page 116 of the Red Book that he wants to give orphan assets, which are unclaimed assets in banks, building societies and—now we learn—life assurance companies, to charity. The victims of failed occupational pension schemes should have first claim on those assets, which would address a real and urgent need caused by a problem that was not of people's own making and which the Government are morally obliged to do something about. The obvious way to do it is through the unclaimed assets, but the Government are turning their back on that route. That is distressing.
	I trust the people of this country to spend their money better than the Chancellor of the Exchequer, and I look forward to taking that battle to the people in an imminent general election.

David Wilshire: May I start, Mr. Deputy Speaker, by apologising to the House? When I originally put in to speak, I thought that I could be present throughout the debate, but my duties as an Opposition Whip made life difficult, as I explained to Mr. Speaker earlier. I am sorry not to have heard all the speeches.
	Every time I hear the Chancellor or the Secretary of State for Health, I am reminded how desperately out of touch with reality they are. As my hon. Friend the Member for Mid-Worcestershire (Mr. Luff) said, they have come to believe their own propaganda. If everything is so wonderful in the NHS, why do my constituents face £17 million-worth of cuts year on year at the Government's insistence? If the NHS is safe in the hands of this Labour Government, why are they trying to privatise part of my local hospital? While Ministers stand at the Dispatch Box and spin away about an NHS utopia, my constituents know different—they know the truth.
	I want to tell the House about the reality of the NHS in my part of Middlesex. My local general hospital, Ashford, started as a workhouse. In 1987, when I became the local MP, it was mainly a collection of wartime temporary prefabs. During the time of the last Conservative Government, it was completely rebuilt. Since 1997, it has suffered cut after cut. In 2000, this Government axed its accident and emergency department, scrapped all its intensive care beds, and stopped in-patient paediatric services. Now, they are at it again. This year, they want to scrap the emergency department, which they gave us when they axed the A and E; scrap all the high-dependency beds, as well as the intensive care beds; and close all 150 medical and acute surgical beds. If they have their way, Ashford hospital will have fewer beds than when it was a workhouse, and my constituents will be left with a first-aid post by day and a telephone to ring for a GP deputising service at night. The reality of the NHS in Spelthorne is not what the Chancellor's spin claims it to be. Small wonder that a former A and E consultant at Ashford said of the cuts that the Government have been making, "People will suffer and some will die."
	That is the reality of what this Government are doing to the NHS in my constituency. The way in which they treat the NHS in Surrey is a downright disgrace. It is underfunded so that money can go to Labour cronies, inadequate allowances are made for the additional costs of providing services in the south-east, and the longevity of my constituents is completely ignored when it comes to working out the demands on services. Listening to the Chancellor last week, one would have thought that the Government would do something to help; but not a bit of it. Their response to the problems in my constituency is to demand more and more cuts.
	If I look back, I can see that the rot set in when the Ashford trust was merged with the St. Peter's trust. That was an attempt to save money by shifting services out of Ashford and into St. Peter's. The result was predictable: St. Peter's could not cope. In due course, a damning National Institute for Clinical Excellence report into its maternity services produced another crisis.
	All that led to something else: no stars when the Government produced their first little league table. The Government brought that on themselves. What did they do? They sacked the chairman and the chief executive and had the bright idea of franchising the management of the trust. The purpose of the franchising exercise was made clear—"Sort out the mess that we, the Government, have made of the services and end the overspending." The Government received and accepted a proposal, but to this day, they refuse to publish the franchise plan. They will not tell us what they agreed and what was meant to happen. I have asked time and again only to be answered with a refusal to publish.
	That probably does not matter now because another financial crisis has overtaken the trust and the franchise plan to which I referred is irrelevant. The current crisis is even worse. The Ashford and St. Peter's Hospitals NHS trust is now breaking the law because it overspends by £17 million a year. On top of that, it has an inherited debt. I note that the Government wrote off the debts of some trusts in some places but because the trust is based in Surrey, which they do not like, I guess that our debt will not be written off.

Paul Farrelly: I am loth to interrupt the hon. Gentleman in full rant, but earlier, I described some of the advances in north Staffordshire, and I should point out that one of the Labour Government's first decisions in 1997 was to give the go-ahead to a brand new hospital in Amersham. I know that because I contested Chesham and Amersham in the general election in 1997. Would the hon. Gentleman describe the hon. Member for Chesham and Amersham (Mrs. Gillan) as a Labour crony?

David Wilshire: No, I would not. When I asked the hon. Gentleman about £17 million-worth of cuts in my constituency, he said that he did not know the position there. Similarly, I do not know the position in Chesham and Amersham, but I stress that the whole of the south-east suffers the same problems and I have no doubt that a Buckinghamshire Member of Parliament would recount that their local health services face the same difficulties caused by having to pay bills and provide services with the money that the Government give them.

Andrew Lansley: If the hon. Member for Newcastle-under-Lyme (Paul Farrelly) had been present in Westminster Hall three weeks ago, he would have heard Members of Parliament from Buckinghamshire making the same point about the unfairness of the financial distribution in the NHS and the deficits in Buckinghamshire.

David Wilshire: That is no surprise. Every time I talk to a colleague from the south-east, I hear the same story.

Peter Luff: I believe that my hon. Friend the Member for Chesham and Amersham (Mrs. Gillan) made that very point at Prime Minister's Question Time last week, and the same complaint as my hon. Friend makes now.

David Wilshire: I must read Hansard afterwards. I am sure that that would give the hon. Member for Newcastle-under-Lyme (Paul Farrelly) and me the answers that we need.
	My trust is breaking the law by overspending by £17 million. The Christmas before last, the position became so bad that suppliers refused to supply the trust until it paid its bills. That is what the Government have done to a trust that tries to provide the services that my constituents want. Their response to the new crisis is not that that the Chancellor boasts about. Given the amount of taxpayers' money that the Chancellor claims to be giving away, one would have believed that we might get some of it. But no, all we have is a loan of £14 million so that we no longer break the law. I must emphasise that the amount loaned is £14 million, not £17 million. There is also a little sting in the tail in that if my trust is good, does what the Government order it to do and makes cuts, keeps quiet and does not complain, the Government will convert the loan into a grant. However, they will do that only if the trust makes the cuts.
	Last September, another interesting development occurred. The Government trumpeted the creation of diagnostic treatment centres—I believe that that name has subsequently been changed. They claimed that that would mean new facilities, more staff and more treatment—the usual spin that we get from the Chancellor and the Secretary of State for Health. They told me that a company called Mercury Healthcare would open such a centre at Ashford. We then discovered why it was that the Government want services moved out of Ashford—so that the Government can privatise part of it. It occurred to me that that amounted to certain hypocrisy, because Labour Members are always accusing my party of wanting to privatise the NHS, but in my constituency the Government are trying to privatise part of the NHS.
	To get to the bottom of this curious development, I thought I would ask Mercury Healthcare all about the new facilities, extra staff and extra treatment on offer. I was dumbfounded when I discovered the truth. Mercury Healthcare is not going to provide any new facilities. It is going to take over one of the wards that has been emptied out by the cuts that the Government have ordered to be made. It is going to take over the theatre, which will no longer be used by the NHS, as the patients have been moved somewhere else. Mercury Healthcare is not even going to employ anyone extra, because it intends to take over the staff that the Government have freed up at my hospital. So much for the spin and the boast about using the private sector to do more, to do it more quickly and to provide better facilities. It is just not true. NHS wards, NHS theatres and NHS staff are to be privatised by this Government, and they have the nerve to accuse us of wanting to do that.
	Just after Christmas, somebody within the trust had a little word with me and said, "Have you asked how the Government's plans to produce this treatment centre are going." I said, "No." I therefore made some inquiries. What did I discover? They had got rid of Mercury Healthcare. I have tabled question after question since, and the Government refuse to tell me when they broke off the negotiations or why. All that they do is point me towards yet another press release, which was issued on 17 February this year. What does it say? Surprise, surprise, five more treatment centres will be opened by the Government, to provide new facilities. Who will run them? Mercury Healthcare—the company sacked from Ashford. The Government take them off one job, put them on another, and claim that they have provided extra centres. That is the spin—that is the way in which this Government act. That is what happens when the Chancellor gets to the Dispatch Box. He tells a tale which he hopes that people will fall for, but they will not when they know the truth.
	Just as a little footnote, the Government still hope to have a privatised facility at Ashford. They still want to get rid of a ward and to get rid of the theatres. They still want to hand over some NHS staff, but now they want to hand them over to a private Swedish company. That is the reality of privatisation—they cannot even use British; they give away their facilities to somebody from abroad.
	The reality of the NHS for my constituents is as I describe it, not as the Chancellor claims. The reality is suffering—let us remember that an A and E consultant said that it may even result in death—not what the Secretary of State claims. As a result of this Budget, and as a result of this Government, my constituents are facing cuts in spending, not more spending. They are facing cuts in services, not improved services. To add insult to injury, they are facing the privatisation of their NHS.
	Last Thursday we were treated to the usual round of spin, boasts, claims—all the false things that we have come to associate with a Government who cannot distinguish reality from fiction. Tonight, like it or not, the Government must face the truth—the truth as my constituents see it: the truth that led 12,000 local people to sign a petition pleading with the Government not to make cuts. There seems to be no sign whatever, at least at the moment, that the Government are paying any attention to that petition. From them it is all spin and no delivery; all waffle, and a complete refusal to listen to my constituents or provide them with a decent NHS.

Stephen McCabe: This may be the only thing I shall have in common with the hon. Member for Spelthorne (Mr. Wilshire) this evening, but like him, I must begin by apologising for being unable to be present for the whole debate. I had other work commitments earlier.
	I congratulate my right hon. Friend the Secretary of State for Health on the commitments that he announced earlier. I note that rather than supporting those advances, the hon. Member for Bury St. Edmunds (Mr. Ruffley) wants to proceed against the non-medical staff in our national health service. I am not sure that I want a health service bereft of security staff: sadly, we need them to protect our nurses nowadays. I do not particularly want to make grand savings by wiping out gardeners in our hospital grounds. I think that medical secretaries do a useful job, indeed an essential one. I think that computer programmers and technicians are crucial to the NHS. By all means let us phase out jobs that we no longer need, but let us not kid ourselves about the people whom the hon. Member for Bury St. Edmunds has in his sights.
	It seems to me that the test of a party's attitude to the NHS is what it does in government. Given the official Opposition's track record, their ever-changing commitments and the constant mantra that their promises are no more than work in progress, it is hardly surprising that many of us have adopted scepticism bordering on cynicism.
	I welcome the Budget, which, as the Chancellor rightly pointed out, hails one of the country's longest sustained periods of growth. I am proud to be a member of a party whose Government can boast the lowest inflation for 30 years and the lowest unemployment since 1973. Despite all attempts by those with a very different agenda to paint an altogether different picture, I am delighted that our Chancellor has ensured that our debt is the lowest of any in the G7 industrialised economies. When I think of what the situation was like when I worked with unemployed youngsters in the late 1970s and early 1980s, I know that this country has been transformed. At that time in the west midlands, it was a novelty to meet a kid who had a father in work—or even a male relative who had had a chance to work.
	Of course there are challenges ahead. There are currently 555,000 vacancies in the economy. We cannot ignore the investment in higher education and skills training that the Governments of India and China are pouring into their economies. I welcome the Chancellor's announcements about education generally, but I particularly welcome the proposals for a new deal for skills and the 10-year framework for investment in the UK's science and innovation base.
	There is an area in which I think we might do a bit more. I want to focus briefly on energy, and renewables and carbon dioxide emissions. It is not clear to me that the Budget has paid quite the attention to those matters that some of us might have hoped. In this country, every year, an estimated 600,000 tonnes of coal mine methane seeps into the air from around 1,000 abandoned or disused former coal mines. That state of affairs, I am told, could continue for the next 50 to 100 years. Coal mine methane has a global warming potential 23 times greater than that of CO2. Capturing coal mine methane and converting it to electricity reduces global warming potential and CO2 emissions by nine times more per kilowatt generated than can be achieved by wind power.
	Why, one may ask, is that area of the renewables market not at the forefront of our energy thinking? The answer is that many companies simply cannot afford it in today's cut-throat, competitive energy market. However, a small shift in the renewables obligation could change all that, and it seems strange that that does not happen given that methane captured from landfill sites or sewage farms is covered by that process. The German Government, I understand, included coal mine methane in their renewables legislation. It could be helpful in terms of energy, reducing emissions and the cost to the health of communities, if I could persuade colleagues at the Treasury to have another look at that.

Paul Farrelly: I did not expect to intervene on the subject of coal mine methane in a health debate but I suppose that there is a health spin-off. I remember my dad converting from methane—the old town gas—to North sea gas years ago. Does my hon. Friend agree, notwithstanding his point about coal mine methane, that it is different from coal bed methane, and that we do not want a lot of mining companies trampling over virgin greenfield land trying to tap into seams of coal under the ground, as they tried to do in north Staffordshire after stripping assets out of local pits?

Stephen McCabe: My understanding is that, although health has served as part of the focus for the debate, it is an economic debate on the Budget and we are relatively free to range across subjects, but I take his point. What he describes would be entirely unacceptable and bears no relationship to the matter that I was describing, which is about trying to recycle coal mine methane in order to produce electricity and in so doing relieve the stress on the environment. I am grateful to him for making that point.
	I am aware that the Budget has been well received in a great many quarters. School teachers in my constituency have told me about their plans to build on the progress that they have been able to make. They are already describing equipment that they will purchase and renew. They are already planning what to do for children in the years ahead. People who work in the skills and training sector are already looking forward to what we can do to develop and boost areas of our economy in which we have real difficulties and deficiences.
	I understand that the director general of the Confederation of British Industry has welcomed the Budget. I noticed that not too many Members on the Opposition Benches referred to that today. Of course, pensioners know the difference between what is really in their pockets and what they have a real guarantee of receiving, and promises that are ever out of reach.
	There is really only one obvious place where the Budget has not been welcome: the Opposition Benches. Rather than acknowledging demands for education, training and investment, rather than celebrating the low level of Government debt compared with that of our G7 partners and rather than congratulating the Chancellor on helping this country to avoid the recessions that have done so much damage to the American and Japanese economies and to those in the eurozone, Opposition Members have insisted that this is a Budget that we cannot afford.
	I have listened with fascination for some time now to the arguments advanced by the right hon. and learned Member for Folkestone and Hythe (Mr. Howard) and by the right hon. Member for West Dorset (Mr. Letwin). They like to tell us that they are changed men—new men, as one of them suggested earlier today: the right hon. and learned Gentleman would like us to forget all about his past.

Paul Farrelly: Is my hon. Friend puzzling, like me, about the real agenda behind Conservative policies? I shall quote what the current chairman of the Conservative party has said about reconstruction:
	"As one of, I think, the unreconstructed Thatcherite free-marketeers in the shadow cabinet, I'm a great believer genetically in markets . . . The biggest problem that we have in the NHS is that it is not a proper market."
	Does my hon. Friend agree that the choice that the Budget poses is Labour investment in the NHS or Conservative cuts and wholesale privatisation of the NHS?

Stephen McCabe: I am certainly not puzzled. I could not agree more with those comments.
	The right hon. and learned Member for Folkestone and Hythe would like us to forget about his past; but, I remember, as do millions of others, what happened to the economy of the west midlands the last time a Conservative Government implemented the policies that the official Opposition now advocate. I have heard the Tories telling us that people are best at deciding how best to spend their tax money, but I remember that Lady Thatcher, as she now is, boasted in 1979 that income tax was too high and that the Conservatives would reduce it and pick up the lost revenues by indirect taxes. That is exactly what they did. It is true that the Conservatives reduced income tax when they came to power in 1979, but in their first Budget, VAT on what were then called luxury items rose from 12.5 per cent. to 15 per cent. and VAT on everything else rose from 8 per cent. to 15 per cent.—virtually double. That is how they believe in people spending their own money.

Andrew Lansley: While the hon. Gentleman is talking about income tax and VAT, perhaps he would like to tell the House and, in turn, his constituents that the Chancellor expects to increase the take on income tax by £15 billion and the revenue from VAT by £10 billion in the next financial year—so there will be more taxes and more taxes again from the Chancellor.

Stephen McCabe: I have no problem with increasing the tax yield in an expanding economy. I do not know anyone, other than the hon. Gentleman, who would find that a problem. The way that the Conservatives trust people to spend their money is by creating the illusion of tax cuts by banging up the VAT rate. That is what they did in 1979, when they also taxed sickness and unemployment benefits and doubled the cost of NHS prescriptions. In their second Budget, they doubled the cost of prescriptions again. While they were doing all that to the British people, they cut public spending on education, schools, health, transport, housing and most other areas. In fact, they cut spending on anything that really mattered. That is the real record, but the Tories talk about affordability and waste. In fact, they were so successful in 1980 that their second Budget was described as the meanest by any Chancellor since 1931.
	What was the effect of that great Tory approach? It was the collapse of industries like a set of dominoes right across the west midlands. We were plunged into recession and millions were thrown out of work. Senior managers and factory floor workers were all the same. Many never worked again, and their sons and daughters became the generation who lived in the workless twilight zone of Tory Britain—a generation purged of opportunity and condemned to be the victims of economic madness, Tory obsessions and Tory prejudice.

Alistair Burt: I am deeply moved by what the hon. Gentleman says but, if that is the case, why on earth did his constituents not vote for socialism at the past two elections? Why do those on the Government Front Bench parade a modern mixed economy? Why do they talk about all the reforms that the Conservative Government introduced on which the Chancellor is now basing the success of his economy? What happened to the socialism that the hon. Gentleman is spouting about? It never worked and never appeared—

Mr. Deputy Speaker: Order. This is meant to be an intervention, not a speech.

Stephen McCabe: The hon. Gentleman should be deeply moved, but he appears to have missed the fact that my constituents and the British public voted in the last two elections for economic sanity as opposed to the economic madness that they suffered under him and his lot, and would do again. At the time that the Tories were doing all that to the British people, they were boasting that it was a price worth paying. I say any price is worth paying to avoid going back to those desperate years.
	My experience and that of most of my constituents and a whole generation in the west midlands tells us that cheap soundbites about credit card Budgets are nothing more than a cover for cuts, recession and untold misery at the very time that we need investment, expansion and growth. That is why I am clear that there is only one man capable of delivering on the British economy. That is why I am delighted to back this Budget.

Andrew Lansley: I am entertained by the hon. Member for Birmingham, Hall Green (Mr. McCabe); I enjoy listening to him. He was at risk of speaking in a way that was interesting and that reflected a certain amount of expertise. The problem is that that was restricted to his discussion of coal mine methane. Everything else was neither interesting nor displayed any expertise whatever.
	Still less did the hon. Gentleman's remarks have anything to do with health. Of course, he was right to say that he was free to talk about other issues, but it is surprising that so few Labour Members have sought to talk about health. Presumably, in Cabinet, the Secretary of State sought a debate on health because he saw it as a priority issue for the Government. However, Labour Members did not agree with him. Thirteen speeches have been made by Back Benchers; nine of them were made by Conservative Members and all but one—I shall return to that point in a minute—spoke about the substance of the issue of health and with experience of their constituencies. Just four Labour Members made speeches and only three of them spoke about health. Apart from the speech of their Front-Bench spokesman, what was the Liberal Democrat contribution? Nothing.
	I am used to Conservatives winning the argument, but I normally expect the Government at least to mount an argument. However, they did not even do that; they simply caved in. They hope that no one is out there watching and that no one cares whether Parliament debates the Budget—still less debates health. Now, for once, we have it on the record that we care about health and what is happening to the NHS. We care about the health experience of our constituents, and we are prepared to debate the substance of the issue.
	Let me say a few words about the Secretary of State's speech. He was invited to blame his predecessor for the current situation and verged on doing so—we are pleased that his predecessor, the right hon. Member for Darlington (Mr. Milburn), is with us and that he contributed to the debate—but in truth, he actually blames his predecessor but one. He made that perfectly obvious when he said that the Government made a start on remedying what they saw as the failings of the NHS with the NHS plan in July 2000. Everything that came before that represented two or three years of completely wasted time—although we have had pretty much six years of wasted time from the Government.
	The Secretary of State made one or two points of substance to which I want to respond. He talked about the additional money in the Budget that is intended for clinical research, which I welcome. As chair of the all-party group on stroke, I welcome the fact that he has included stroke among the three diseases—Alzheimer's, stroke and diabetes—on which there will be an additional emphasis on clinical research. I hope that he and his colleagues will ensure that research on stroke is directed not only at the disease itself, but at rehabilitation and how we can best achieve that.
	If I may digress for a moment, it is interesting to note the lack of research on stroke compared with the main diseases of cancer and coronary heart disease, so the announcement is extremely timely. We need to begin to understand better the circumstances in which we could intervene early during stroke management and stem the extent of the disease. In the past, we tended to say that if people have a stroke, they are admitted, and that if we are lucky, they are admitted to a specialist stroke unit. Perhaps the Government will be able to tell us at the end of next week how many people are admitted to specialist stroke units. Unfortunately, the figure will not be 100 per cent., which ought to be the target in the national service framework for older people.
	In the past, we tended to say that the degree of disability and deficit that results from a stroke is pretty much fixed and that the effects can be mitigated only through rehabilitation. However, in the future—perhaps research will enable us to identify this—we may be able to use new treatments such as Desmosteplase, which is in use and licensed in America. Although imaging is required for such treatments, their use in early intervention tends to reduce the extent of stroke deficit. Tens of thousands of people are affected by stroke each year and we might be able to reduce the extent of their disease. I welcome the research on stroke. When we discuss health, it is important to talk about health issues rather than only funding and how much money should go where, which is why I welcomed what the Secretary of State said.
	The Secretary of State briefly mentioned drugs for children. I commend the work carried out before the 1997 election by the Select Committee on Health under the chairmanship of my hon. Friend the Member for Broxbourne (Mrs. Roe). The Committee published reports on children's health just prior to that election, one of which drew specific attention to the lack of clinical trials of such drugs, and especially the lack of drugs for which there were protocols on, and indications of, the extent to which they were suitable to be prescribed to children. It is important to begin to remedy the problem so that we have greater confidence in the system.
	I reiterate the point of principle on which our approach to the NHS is based, which my hon. Friend the Member for South Suffolk (Mr. Yeo) set out: it should be free at the point of use and based on need, not on the ability to pay. The Secretary of State retreated in confusion on that point. He argued at the Dispatch Box that we should spend more in the private sector than my hon. Friend suggested.

John Reid: There is no confusion. I ask a question to which I did not get an answer—perhaps the hon. Gentleman can enlighten us. The hon. Member for South Suffolk (Mr. Yeo) insisted that the Conservative party is committed to equity of access. How can two people have equal access to an operation if that is dependent on them both having half the cost of the operation?

Andrew Lansley: The Secretary of State misses the point again. We have made it clear that the patients passport will be a mechanism for the delivery of patient empowerment. It will give patients control over their health care. It is astonishing that he does not understand when he is playing grandmother's footsteps with the Conservative party.
	At the Conservative party conference in Harrogate two or so weeks ago, my hon. Friend the Member for South Suffolk made it clear, just as we made it clear at our last party conference that we wish to extend the patients passport to chronic disease management, that we are starting work on how we will achieve that, as he reiterated today. It involves placing particular emphasis on diabetes and asthma, as early diseases that would qualify for that approach, and empowering patients to control their health care. That happened on the Saturday. Lo and behold, the following Thursday, the Secretary of State went to a conference organised by The Guardian—the type of event to which he tends to go—and announced that he intends to focus on chronic disease management and self-management of such diseases, with an emphasis on diabetes and asthma. We are forging the way in the health debate.
	The Secretary of State needs to persuade his hon. Friends of his policies. The hon. Member for Newcastle-under-Lyme (Paul Farrelly) spent most of his speech attacking the concept of patient empowerment. He is not interested in the idea that someone might choose the type of health care that they receive and where they receive it. He wants the money spent in his local hospital and does not want anyone to choose anything else.

Paul Farrelly: rose—

Stephen McCabe: rose—

Andrew Lansley: I shall give way to the hon. Member for Newcastle-under-Lyme, because I just referred to him.

Paul Farrelly: I welcome the hon. Gentleman's return to the Front Bench. He was a talent wasted on the Back Benches. I also know him to be a reasonable man. Does he truly believe in the voucher, the visa or the passport policy, or is it something that he inherited?

Andrew Lansley: Before the hon. Gentleman chides me on policy, he should find out about his party's policy, because the Government have been chasing us. For heaven's sake, it is his party's policy increasingly to use the private sector. The Government have been buying services at 143 per cent. of the NHS cost. According to the The Times today, they are negotiating for bulk purchasing in the private sector. We want independent health care providers to stand alongside NHS providers. Our interest is in ensuring that patients get the health care they need and not to be hide-bound by an idea of who provides it, whether it is NHS owned or independent.
	The detail of the Government's plans often reveals that choice is limited. Rather than providing choice at the point of referral, it is choice after six months. As my hon. Friend the Member for South Suffolk said, it is not a choice of any hospital across the country—a genuinely national health service—but a choice of the specific hospitals that the Government say people can go to. My hon. Friend the Member for North Dorset (Mr. Walter) told us about his constituents who were not allowed to be referred to the Royal Surrey County, even though that was their choice. Just as this Government did away with extra-contractual referrals and out-of-area treatments, and have introduced limited choice within the NHS, only a Conservative Government will restore choice to my hon. Friend's constituents.

Patsy Calton: Will the hon. Gentleman give way?

Andrew Lansley: No, I have only a few minutes left and the Liberal Democrats did not participate in the debate to any extent.
	The right hon. Member for Darlington made some important points. I want to mention just one—his conversion to increasing home ownership, as one of my hon. Friends put it. Given the right hon. Gentleman's record at the Department of Health, surely he could help to shift the definition of affordable housing away from a definition of social housing, which is geared to the rented sector and, in particular, the housing association-owned rented sector, to one that offers opportunities of equity stakes for those in key-worker housing. That would be enormously helpful. That is what people around Addenbrooke's hospital in my area want. They do not want to rent. They want the opportunity to buy, and if they cannot buy the whole of a property, they want to have some equity in it.
	I must not be too unfair: the hon. Member for Sutton and Cheam (Mr. Burstow) did make a speech. He talked about our policies, but he neglected, so far as I could tell, to say anything about Liberal Democrat policies. In particular, he neglected to tell anybody that the Liberal Democrats appear to be opposed to patient choice, but he did talk about public health.
	The Secretary of State did not talk about public health very much. In particular, he did not give us the opportunity to ask him why he supposes that, in a recent survey of doctors published in "BMA News", 78 per cent. of those who responded said that they were not confident that the Government could or would achieve significant improvements in public health. That is exactly why my hon. Friend the Member for South Suffolk and other colleagues put improvements and a new strategy for public health at the forefront of our policies—there is no confidence in the Government on that matter.

Patsy Calton: One thing that the hon. Gentleman failed to note is that my hon. Friend the Member for Sutton and Cheam (Mr. Burstow) asked where the £1 billion of dead money for the patients passport is. I should be grateful for an answer.

Andrew Lansley: I should be glad to answer the hon. Lady, who at least had the patience to listen to the whole debate, but I confess that I do not remember the hon. Gentleman saying that. I must have been in the midst of a rather dull debate. Since the hon. Gentleman had nothing to say about his own policy, however, I shall not bother to say too much. If the hon. Lady wants to chide us about policies, she might like to remind the House that in the debate on foundation hospitals she was against the principle of those hospitals, but when challenged on the fact that in her constituency she supported Stockport district general hospital, which I have visited, in becoming a foundation trust, she said, "Well, of course, in the Liberal Democrats, one changes one's principles according to the circumstances."

Patsy Calton: Will the hon. Gentleman give way?

Andrew Lansley: No, I have given way to the hon. Lady once, and that is enough.
	The hon. Member for Luton, North (Mr. Hopkins) told us a little about his views on the Budget, which should worry the Chancellor because, basically, that consisted of agreeing with the Chancellor that his borrowing an enormous amount of money was a good thing and, if there was one criticism, it was that he was not going to put the price of alcohol up by 10 per cent. I am not sure how that will go down in Scotland, and with the Scotch Whisky Association.
	My right hon. Friend the Member for South-West Norfolk (Mrs. Shephard) departed from the subject of health to tell us some very important things about biofuels. If I may, I will simply say that, from my perspective in East Anglia, I share her view of the importance of giving credibility to the Government's acceptance of the EU biofuels directive and their commitment to 2 per cent. biodiesel by 2005, and the necessity of showing how those targets will be achieved.
	The hon. Member for Plymouth, Sutton (Linda Gilroy) told us about Derriford hospital and went into the subject of payment by result, which I hope Ministers will take note of. I must confess, however, that I would be surprised if she got much of a reception among her colleagues for her criticism of the market forces factor, since that is one of the components of a distribution factor that so benefits the constituencies of Labour Members as compared with the way in which NHS resources are distributed among Conservative Members' constituencies.

Linda Gilroy: Will the hon. Gentleman give way?

Andrew Lansley: No, I do not have time. I must respond to the points made in the debate.
	My hon. Friend the Member for North-East Bedfordshire (Alistair Burt) made some very important points, and I want to echo two of them. The first was about the GP contract. I know from correspondence with Bedfordshire Heartlands PCT that it is concerned about where the money will come from. That concern has recently been reflected in "Health Press". The cost to the trust of running an out-of-hours service is to rise from £1 million to £1.9 million, and the Government's proposals, including the recent announcement by the Minister of State, Department of Health, the right hon. Member for Barrow and Furness (Mr. Hutton), will only take it to about £1.5 million, so it is looking at finding £400,000 from somewhere to maintain the service.
	On a positive point, I shall not chide the Minister of State because I hope that he will be able to deliver for my hon. Friend on the subject of the Primrose appeal and the associated costs. I leave that with him. We will thank him if he is able to deliver satisfaction for the appeal by turning charitable donations not into tax but into the cancer centre for which they were subscribed.
	My right hon. Friend the Member for North-West Hampshire (Sir George Young)—[Interruption.] It is all very well the Secretary of State not listening to me speak—I am used to that—but neither he nor any of his colleagues at the Department of Health came to hear my right hon. Friend speak. They would have learned a great deal had they done so, and I recommend that they read his speech tomorrow, because it illustrated the problems that are being experienced in the areas represented by Conservative Members. Deficits of more than £20 million are reported in Hampshire and Isle of Wight strategic health authority and in the Surrey and Sussex strategic health authority, and similar deficits are anticipated at the end of December in the Norfolk, Suffolk and Cambridgeshire strategic health authority. Then—lo and behold—came the hon. Member for Newcastle-under-Lyme (Paul Farrelly) to say that no deficits were reported in his area. Well, that is a surprise. I wonder how that happened.
	My right hon. Friend the Member for North-West Hampshire also made it clear that the Secretary of State had managed to come to the Chamber and give a speech about health but not talk about all the things that people working in the health services are talking about. They are talking about NHS IT, GP contracts, consultants' contracts, the European working time directive, payment by results, the tariff, and foundation trusts, but the right hon. Gentleman mentioned none of those subjects. People in the NHS might wonder why he omitted them from his speech, but we do not. He missed out all those things because they are problems, and the Secretary of State did not come here to dwell on the problems. He came here to talk about our policies, not about his.
	My hon. Friend the Member for North Dorset spoke about the problems that his constituents are experiencing, and my hon. Friend the Member for Reigate (Mr. Blunt) referred to the European working time directive. The hon. Member for Newcastle-under-Lyme—I am sorry to mention him again—spoke about Keele university and all the additional medical students training there. Well, good—they will be needed, because the BMA estimates that if Labour Members of the European Parliament, who voted to get rid of the opt-out from the working time directive, have their way, by 2009 we will need 9,900 more junior hospital doctors to cope with the demands of that directive. Those demands will hit us this August, and they are causing many in the NHS real concern.
	My hon. Friend the Member for Fareham (Mr. Hoban) referred to relocation issues—I suppose that last Wednesday's announcement of 1,000 jobs to be lost to his area hit like a Titchfield thunderbolt. He also spoke about lack of accountability in planning and housing in the south-east and the east of England. I entirely share his view: that is a disgrace.
	I have referred to the hon. Member for Newcastle-under-Lyme sufficiently. My hon. Friend the Member for Bury St. Edmunds (Mr. Ruffley) reminded the House that only the Conservatives can offer the real structural reforms that are required. My hon. Friend the Member for Mid-Worcestershire (Mr. Luff) drew our attention to the tax increases that already appear in the Red Book, quite apart from the further tax increases that will be required if the evidence of revenue shortfalls and overruns in borrowing is accurate. My hon. Friend the Member for Spelthorne (Mr. Wilshire) quoted personal experience of the effects on the NHS in his constituency, which comes within the North West London strategic health authority—

David Wilshire: Surrey and Sussex.

Andrew Lansley: The Surrey and Sussex SHA, which also covers the constituency of our hon. Friend the Member for Reigate and which anticipates deficits of more than £20 million.
	The debate was pretty much a walkover. We know what the link between the NHS and the Budget is. As my hon. Friend said, the Chancellor is in the casino; he is playing not with his own chips, but with ours, and he looks like he might lose. When he cannot manage the risks, who will take the losses? It will be the NHS that has to pay. Just as we have seen him do in the past, the Chancellor will make promises on which it is impossible for him to deliver. The Conservatives have the policies that will ensure that we can support the NHS with the resources that are required to improve health care to the standard that we need, and those resources will not be prejudiced by future demands for additional taxation or a collapse in the public finances. Only under the Conservatives can the NHS be safe.

John Healey: We have had a good debate. I shall do my best to deal with the points that have been raised in the time that is left to me, which will be less than the time that was available to the hon. Member for South Cambridgeshire (Mr. Lansley). I shall pay particular attention to those who contributed to the debate and still remain in the Chamber.
	A central fact at the heart of the Budget statement and this debate is that since 1997 Britain has sustained growth through not one but two economic cycles. Since 2000, our growth has outperformed the EU area, Japan and even the United States. Since 1997, Britain is the only developed country that has grown in each and every quarter in spite of the recent world downturn, and in spite of our record, which was that Britain was usually first in and last out and suffered more in any world downturn that we experienced.
	On Wednesday, my right hon. Friend the Chancellor of the Exchequer confirmed that last year the British economy grew by 2.3 per cent., meeting the Treasury's expectations and confounding the predictions of Opposition Members and many individual commentators. It was only in November 2003 that the shadow Chief Secretary to the Treasury said:
	"There are now growing threats to growth and stability."
	In April last year, the then shadow Chancellor and now Leader of the Opposition said:
	"The Chancellor has misrepresented Britain's economic prospects in the past and he is now once again being less cautious than independent experts."
	In addition to sustained growth, we have had the lowest inflation for 30 years, the lowest interest rates since 1955 and the lowest levels of unemployment since the 1970s. Britain is closer to full employment now than it has been for a generation. New unemployment figures published on the day of the Budget show that since 1997, 1.8 million extra jobs have been created in the British economy, with 1.3 million in the private sector.
	This economic position is supported—it will continue to be supported—by the fiscal discipline that is at the heart of our strategy for long-term stability. We have met our fiscal rules. In addition, debt this year is just 33 per cent. of national income. Net borrowing is 2.4 per cent. of GDP and falling over the forecast period. Both figures are lower than in the past, and both are lower than the rates of our major competitors in the industrialised world. The challenge now is to combine this new confidence in Britain's economic potential with a new determination to make the long-term reforms and investment that will secure stability and growth for the future.
	My right hon. Friend the Chancellor of the Exchequer set out in the Budget some of the necessary investments that we have to make in science, education, skills and enterprise in our country's wealth-creating and job-creating base. He made it clear that he will not neglect the need for long-term investment and will impose an annual balanced budget rule. A policy in contradiction of that, whether imposed by a future Government or by a rigid interpretation of the European stability and growth pact, would repeat the mistakes of Britain's stop-go past and put at risk our stability and growth. It would be a return to stop-go for the economy and a go-stop for public services. My right hon. Friend the Member for Darlington (Mr. Milburn) and the hon. Member for Sutton and Cheam (Mr. Burstow) made the link between a sound economy and strong public services much clearer in their contributions.
	My right hon. Friend the Member for Darlington said that health investment performs an economic function. He added that NHS reforms have delivered health benefits and economic benefits. He went on to say that the same is true in spades for education and child care. That is why the debate has been dominated by public service spending plans. At the same time, it is an essential part of the debate about Britain's economic management and prospects for the future.
	The hon. Member for South Suffolk (Mr. Yeo) made what he termed an important announcement. He said that a future Tory Government would not introduce tax relief on private health care insurance. That is the unmistakeable sound of a hasty retreat. It is the unmistakeable sign of a policy that is at sixes and sevens. Neither the hon. Gentleman nor the hon. Member for South Cambridgeshire answered the challenge of my right hon. Friend the Secretary of State when he asked, given the patient's passport plan, how could they honour the pledge that was made this afternoon that there would be equal access to all in the NHS, free at the point of delivery.
	Let us be clear: the plans for health and the health passport would take money out of the NHS to subsidise the private health care industry. It would be used to help the privileged few to jump the queue. Most hard-working families could not afford the £8,000 that they would need to find for a heart bypass operation. They would not be able to find £5,500 for a knee operation, or £4,000 for a hip replacement operation. It is a plan to promote private health care and it would end an NHS free at the point of use—that is what the hon. Member for South Suffolk espoused as the new Conservative path.
	Pupil passports were mentioned in the debate, and Conservative spokesmen are at sixes and sevens over that policy too. On 22 February, the shadow Chancellor said that the money for pupil passports could be used for "cheap private schools" and that parents could top it up. Over the next fortnight, that was confirmed, repudiated, reconfirmed and repudiated again. On 11 March, the shadow Chancellor ruled out using the passport at fee-paying schools. Five days later, the hon. Member for South Suffolk said that parents could spend the passport at fee-paying schools, but could not top it up. The policy has changed half a dozen times in half a dozen weeks, so can anyone be confident that it is not about to change again? It is clear, however, that money will be taken from mainstream schools to subsidise the private education sector and help the privileged few at the expense of every other pupil and student.
	I shall pass over the contributions of the hon. Member for Sutton and Cheam, who is not in the Chamber, and of my hon. Friend the Member for Luton, North (Mr. Hopkins) who, sadly, is no longer in his place. He welcomed the public investment, and I know that he will warn his constituents of the jeopardy to transport and the other things that he mentioned if the Opposition should ever assume office. The right hon. Member for South-West Norfolk (Mrs. Shephard) takes a special interest in biofuels, and she makes sure that I do too. I appreciate her welcome for the Budget measures that she described as positive. I accept that she wants us to go further, but she will welcome the confirmation in the Budget that we are prepared to consider and consult on a biofuels obligation. The right hon. Member for Fylde (Mr. Jack) and my hon. Friend the Member for Sherwood (Paddy Tipping) will do so too, and I look forward to further representations from the right hon. Member for South-West Norfolk and the all-party alliance that she has established.
	The hon. Member for North-East Bedfordshire (Alistair Burt) was poetic about the undisturbed peace in Biggleswade last week. I am glad that he welcomes the extension of the VAT scheme as a zero rate on the repairs of listed churches. He was concerned about the Macmillan Primrose appeal, and asked me to investigate. In recent months, I have been much more heavily involved in the issue than he might expect, and I can confirm that the Government have given a commitment that the NHS will meet the VAT costs of projects deemed to be priorities of local cancer networks.
	The right hon. Member for North-West Hampshire (Sir George Young) wanted a stronger link between NHS investment and improvements in the service—a point to which I shall return. He asked about photodynamic therapy for people with macular degeneration. I suspect that he knows that the National Institute for Clinical Excellence issued guidance in September, and in the same month the Department of Health issued guidance to vary the usual three-month funding directive because of the need both to expand services for those patients in a planned way and to recruit and train staff across the country.
	The hon. Member for North Dorset (Mr. Walter) raised the case of a constituent and funding for his treatment. It is impossible for me to respond, but I am sure that my right hon. and hon. Friends from the Department of Health will consider it, along with the comments of the hon. Member for Spelthorne (Mr. Wilshire), who made a heated contribution about the position of his local NHS trust. The hon. Member for North Dorset complained about the operation of NHS Direct, but last year it received more than 6.3 million calls—almost three times the number of calls it received three years ago. Increasingly, it is gaining the support of patients and the medical professions, and it is part of the reformed service delivery that we need in future. He tried to use detailed figures to argue that the Budget showed that the Government will break the golden rule and that it confirmed tax rises in future.
	The hon. Member for Bury St. Edmunds (Mr. Ruffley) tried to do the same. I say to them both that precisely the opposite is true. We have kept every promise that we have made on tax and we will continue to do so. We have met the fiscal rules that we have set and will continue to do so. We have set out our commitments to invest more in public services. We have shown that they are fully funded, and they are fully funded on the cautious case that one would expect of a Government.
	The hon. Members for Reigate (Mr. Blunt) and for Bury St. Edmunds commented on productivity in the NHS. The definition of productivity is narrowly focused on what consultants do, and they make up only 7 per cent. of what the NHS does. I remind hon. Gentlemen that in March 1997 over 30,000 patients were waiting more than 12 months for treatment. At the end of January this year the figure was 36.
	My hon. Friend the Member for Birmingham, Hall Green (Mr. McCabe) mentioned coalmine methane, and I will consider the points that he made. I remind him that we have already exempted the generation of electricity from coalmine methane sources from the climate change levy, and we have put in place an unprecedented level and length of support to underpin the renewables obligation.
	Despite the Opposition's efforts to run down the improvements, our past investment in health was demonstrated by the practical changes that my hon. Friends the Members for Plymouth, Sutton (Linda Gilroy) and for Newcastle-under-Lyme (Paul Farrelly) described in their constituencies. Every Member of the House can see that progress is being made in their constituency. In my own area in South Yorkshire there are 1,170 more nurses attending to patients in the NHS now than there were in 1997. Our investment in health nationally has already led to an increase of 67,500 nurses and 19,000 doctors since 1997. We have funded the largest ever hospital building programme, improved GP premises, increased the number of beds and decreased waiting times for operations and emergency care. In answer to the hon. Members for Reigate and for North-East Bedfordshire, I point out that last year elective admissions increased 21 per cent. on 1997. That is equivalent to almost 1 million extra hospital admissions. That is no trifling increase in output, as the hon. Member for Reigate suggested.
	In the Budget we have allocated an additional £100 million to NHS research and development. I am glad the hon. Member for South Cambridgeshire (Mr. Lansley) welcomed that. Together with increases to the Medical Research Council, we expect the increase to exceed £150 million per year.
	On education, we have announced in the Budget £8.5 billion extra for UK education in 2007–08 compared with 2005–06—an average annual increase of 4.4 per cent. in real terms across the 2004 spending review period. There will be more bad news for the education sector if the Tories get in. Andrew Neil asked the shadow Chancellor the day after the Budget whether he would match the extra spending on education. The answer:
	"No, we'll stick with our plan."
	We have outlined proposals to boost productivity and growth in the economy through a new deal for skills and a 10-year framework for investing in the UK's science and innovation base. Any serious debate in the House or in the country must set out these Labour commitments alongside the plans of the Opposition. The shadow Chancellor has made it clear that he would impose a two-year cash freeze, which means a 5 per cent. real-terms cut. We look forward to hearing how his Front-Bench colleagues will explain to local councils the projected cut of £2.4 billion, how they will explain to those who need child care the projected cut of £340 million, even before the new Budget announcements were taken into account, and how they will explain to those who are most impoverished and most needy across the globe, and to those who try to help them through international development, the projected cut of £229 million.
	The shadow Chancellor has committed the Tories to 5 per cent. cuts in the law and order budget. That is the equivalent of sacking 1,300 police officers. At a time when we are stretched in Iraq, Afghanistan and Kosovo, he has committed them to cut the defence budget by 5 per cent. in real terms. It is not just that they leave us defenceless at a time when we need defence, insecure when we need security and weak when we are in troubled times. It is worse than that. All the major investments we need for the future, they would cut. The very drivers of prosperity would be cut—science cut, skills cut, transport cut, apprenticeships cut, university places cut, further education courses cut and workplace training cut. This Budget and this Budget debate make clear the choice before the British people: cuts, charges and privatisation under the Tories—
	It being Ten o'clock, the debate stood adjourned.
	Debate to be resumed tomorrow.

COMMITTEES

Foreign Affairs

Ordered,
	That Richard Ottaway be discharged from the Foreign Affairs Committee and Mr Andrew Mackay be added.—[Mr. John McWilliam, on behalf of the Committee of Selection.]

Treasury

Ordered,
	That Mr David Ruffley be discharged from the Treasury Committee and Mr David Heathcoat-Amory be added.—[Mr. John McWilliam, on behalf of the Committee of Selection.]

LONGLEVENS POST OFFICE

Motion made, and Question proposed, That this House do now adjourn.—[Paul Clark.]

Parmjit Dhanda: There can be few occasions on which a Member of this House relishes being forced to rewrite his or her speech just hours before a debate. This, however, is such an occasion. It is also an occasion that has taught me something about the strength of this Chamber and of Adjournment debates, and about the difference that they can make. I have had to amend my speech several times during the day because of the negotiations that I have been in with the private sector today. I shall elaborate on that and on the effect of those discussions, which have been very positive with regard to issues that affect my constituency.
	Five hours ago, my constituents in Longlevens were despairing at the prospect of losing their local post office. I shared their anger about the way in which they had been treated. I knew how important it was to save that vital service, so in recent weeks, I have worked with local people in Gloucester, organising petitions, meeting them in Parliament and even raising the matter with the Prime Minister two weeks ago in Prime Minister's Question Time.
	This evening, we took several steps forward towards achieving a result, although we still have some way to go to resolve the issue totally. I would like to take this opportunity to explain the background to the situation, to discuss the points still to be resolved and to seek the Minister's advice on the wider issues raised by the recent controversy in Longlevens in my constituency. It is a controversy from which I believe that there is a great deal to learn, and my experience of today shows that some learning is going on at the present time as a consequence of the experience.
	In recent years, it has become a commonplace that communication has been transformed somewhat by innovation. For many of us, air mail has been replaced by e-mail and the lick of a stamp has been superseded by the click of a mouse. In such circumstances, it can be all too easy to forget the importance of our local post offices. The residents of Longlevens in my constituency value their local post office enormously. Unfortunately, that service was recently put in great danger. The licence for the Longlevens branch has very recently been acquired by Tesco, which gave just three months' notice that it intended to close the branch to create more space in its local store. My constituents in Longlevens are unhappy about the way in which the decision was taken, and so indeed am I. I am also concerned about the wider implications of closing the post office in terms of the national picture, and I hope that the Minister will be able to elaborate on that point.
	That is why my office and I were so pleased this evening when I received the latest fax from Tesco; I have had two faxes during the day. It has now said that it will not shut the post office on 8 May, as it had originally intended. It has made this promise:
	"it will remain in the One Stop"
	store
	"while we search for a new location."
	Of course, there is still much more to be done, and a new location in Longlevens must still be found, but I welcome this significant step forward by Tesco.
	I shall elaborate on that letter, which contains three key concessions made today. First, Tesco says:
	"Following our conversation earlier today . . . the resignation date of 8 May has been withdrawn."
	I certainly welcome that.
	Secondly, on a financial level, Tesco says:
	"We understand that the cost of relocation may be deterring some of those who might consider taking on the relocated post office business. To overcome this, we have agreed with Post Office Ltd. an alternative arrangement whereby the contract transfers directly from Tesco to the new business. This would enable Tesco to significantly reduce the potential cost of relocation—we will not seek any goodwill payment for transferring the post office as a going concern and will contribute to the cost of physically relocating the post office."
	I also welcome that.
	Equally significantly, Tesco made a third concession hours before this debate, when it said:
	"In order to maximise the opportunity for a post office to be transferred, it will remain in the One Stop"
	shop
	"while we search for a new location."
	I welcome all three concessions.
	It may help if I go into further detail about the issue in Gloucester. In January 2003, Tesco purchased the T and S Group, which owned 318 stores containing post offices nationally. Although it stated that it would retain many of those post offices, reports suggest that up to 100 of them could close. It promised that it would give six months' notice wherever possible before closing a post office. In the case of Longlevens, however, it decided that it would only give three months' notice.
	I say to Tesco, "Why the rush?" Post Office Ltd. is due to publish its area plan in the third quarter of this calendar year detailing the need for local post office provision in Gloucester. Tesco pre-empted the plan by deciding to close Longlevens before it saw what the plan had to say. It also failed to seek the views of local people, who were utterly dismayed by the total lack of consultation. Indeed, the public interest did not seem to feature in its initial calculations.
	In my view, that is evidence of a wider lack of strategic thinking about the future of post offices in Gloucester and a lack of effective co-operation between Post Office Ltd. and Tesco. This incident, and others like it, threatens to undermine the Post Office Ltd. urban reinvention programme. Under the programme, the Oxstalls branch, which is also in Longlevens, was recently closed. Since Longlevens is just 0.9 miles away from the Oxstalls branch, it was subsequently designated as a "receiving branch", but now it, too, is threatened by closure, and its future remains uncertain. Post Office Ltd. is obliged to ensure adequate provision for customers in this area. If two neighbouring branches close within months, how can that obligation possibly be kept? The simple answer is that it cannot.
	The closure seems to have surprised Post Office Ltd. as much as it surprised me and, indeed, everybody else. The situation could be exacerbated further because of uncertainty about the future of the nearby Barnwood post office. A planning application has been submitted that would involve the Barnwood site being knocked down to build flats. The operator of a nearby filling station has, however, indicated its willingness to take on the post office in Barnwood on its own site, but it is reluctant to do so until Post Office Ltd. has clarified its views on the future of services in the area plan, which will not be ready until autumn this year.
	As a consequence of that, it is not inconceivable that one 12-month period could see the closure of Oxstalls, Longlevens and Barnwood post offices, resulting in a massive gap in post office provision in the north and north-east of my constituency. If one draws an imaginary circle with a 1-mile diameter around the Barnwood post office, as I have, one will see that the community that it serves includes part of the Elmbridge and Longlevens communities, which would be hit again.
	In those circumstances, it is not surprising that the local community in Longlevens has come together in opposition to the plan. I cannot overemphasise to my hon. Friend the Minister how strongly local people feel about this. Thousands have signed petitions such as those organised by me and by The Citizen newspaper, and many more have phoned BBC Radio Gloucestershire, particularly the Mark Cummings mid-morning show—all calling on Tesco to think again. Tesco's letter demonstrates that it has listened, to some extent, and I welcome the dialogue that it now seems willing to take part in.
	The closure of any post office will cause unhappiness among its users, but I think that I have shown that the situation in Longlevens is particularly serious. Since neither you, Mr. Speaker, nor my hon. Friend the Minister have, to my knowledge, had the privilege of visiting Longlevens—although you are both welcome at any time—I want to talk a little more about the community there. Longlevens is a thriving neighbourhood with between 8,000 and 9,000 residents. On the same street as the post office is a wide range of shops, including the Co-op supermarket, a bakery, a pharmacy and a greengrocer. As the Post Office itself would agree, the post office is not an isolated, struggling service that cannot be justified economically or socially, but in many ways the hub of its local community.
	Longlevens post office is especially valued by local pensioners. More than 22.8 per cent. of the population is aged over 60—that is higher than the average for Gloucester, which is in turn higher than the average nationally. Many of those pensioners are worried that they will no longer be able to rely on having such an important amenity at a close walking distance. Can we really expect them to walk several miles once or twice a week to what will, for some of them, be an unfamiliar part of town? The benefits that they derive from the post office do not relate solely to the transactions that are processed there. For many lonely senior citizens, a weekly or twice-weekly visit to the post office and other nearby shops is an important means of maintaining social contact with others.
	That point was well made by my constituent, Jackie Dee, who runs the greengrocers two doors from the post office, and who visited Parliament with her family a fortnight ago on Wednesday. Jackie and her family feel a strong sense of duty towards their local community. They know their customers well and provide them with a valued service and friendship. It is their friends and customers who will lose out as a result of the closure of the local post office. To rub salt into their wounds, Sir Terry Leahy, Tesco's chief executive, told one of my constituents—presumably in a circular letter or round robin—that the post office counter would close to provide space for a much wider range of fruit, vegetables and healthy eating options. But residents can already get that at the greengrocers run by Jackie Dee just two doors away from the post office, as Tesco could easily have discovered with a little local research—what residents want is a post office.
	What can be done about the situation? In recent weeks, I have engaged constructively with local people, Tesco, Post Office Ltd. and Postwatch, which has been very helpful. It would be foolish to make any decision on the future of the post office in Longlevens until POL has published its area plan. After all, that document will provide the context for taking strategic decisions about the future of post offices.
	I therefore asked Tesco to defer a final decision until the area plan was made available. Until earlier this evening, the last trading date was set to be 8 May. I asked Tesco to postpone that and give the people of Longlevens the same extensive period of notice as it gave other post offices that it intended to close elsewhere. I welcome its response, which was made only hours before the debate. I also seek a specific guarantee that Tesco will not close the post office until an alternative location has been found and is ready for business. The guarantee, "while we search" in the letter should ideally read, "until we have found" a new location.
	I understand that the Co-op has shown an interest in taking over the local branch from Tesco and would keep it in Longlevens. A local church and shops are also being pursued as possible relocation options. I should be grateful if the Minister encouraged Post Office Ltd. to take into account, when drawing up its area plan, the uncertainties surrounding the future of the post offices in north-east Gloucester. It should take all necessary steps to meet its obligation to ensure adequate provision for customers in Longlevens.
	The people of Longlevens have made a strong case for keeping a post office in a central location in the neighbourhood. We know that such a post office is economically justifiable as well as socially desirable. Post Office Ltd. would agree with that. We know how hard local people are prepared to work to ensure that their voices are heard. We also know the Government's commitment to investing in strong communities. I therefore hope that if we all—the Government, the Post Office, Tesco and, most important, local people—work together, we can save the service and ensure that Longlevens remains a thriving community and a great place to live.
	I confess to being a Tesco cardholder, like many people in Gloucester. I shop at the Tesco store on the cattle market site in my constituency at the weekends. I have held street stalls there; the staff are always friendly and accommodating. That also applies to the staff at the Quedgeley Tesco supermarket, where I have held many surgery sessions. They have been helpful in the past and I am sure that they will be again in future. That is why I believe that it is important that Tesco works with the local community and retains a good relationship.
	Headlines such as "Church attacks Tesco on Post Office closure" and "Boycott threats over closure plans" in The Citizen demonstrate the strength of local feeling on the issue. I intended to say, "By at the very least extending their date of notice until we can secure an alternative site for a post office in Longlevens, Tesco can help redeem itself", but it has already gone a long way towards doing that today. In many ways, it is a shame that it has taken until today for that to happen, but I welcome the decision none the less.
	I hope that Tesco will now work with Post Office Ltd., Postwatch and local communities on the reinvention programme to stop the same thing from happening around the country. Earlier today, I was informed of similar incidents in Aylesbury and Swindon. As a result of Prime Minister's Questions and the Adjournment debate, I am conscious that Longlevens has the most famous post office in the country. However, all I want is to ensure that the community continues to have a post office. I am determined that we will succeed.

Stephen Timms: I congratulate my hon. Friend on securing this debate and, as we have heard, on the developments for which this debate has provided a catalyst. I am grateful to him for letting me know the concerns that he wanted to raise, which gave my officials an opportunity to make some urgent inquiries today.
	My hon. Friend spelled out clearly the importance of good access to the local post office, and he highlighted the implications of Tesco's intention to remove the post office from its store at Longlevens. Of course, Tesco's decision is a commercial matter for the company. It does not stem directly from Government action, but I recognise the uncertainty that it has placed in the minds of my hon. Friend's constituents, and I want to respond to a number of the important points that he has made. We all share concerns about the future provision of post office services in our constituencies. The Government are fully committed to maintaining a viable nationwide network of post office branches.
	The Post Office is undertaking a restructuring programme of its network in urban areas. I have responded in a number of debates in this Chamber and in Westminster Hall to hon. Members who are anxious to make sure that the rationalisation of post offices in their areas does not disadvantage their constituents. Recently, I have heard from a number of hon. Members who are concerned, like my hon. Friend, about Tesco's intentions for post offices within its stores. Tonight's debate will help to clarify what is going on and, I hope, help to alleviate some of the current uncertainty.
	The Longlevens post office has not been proposed for closure under the Post Office Ltd. urban post office reinvention programme. It is necessary to draw the distinction that a removal from a Tesco store does not equate to a permanent closure of a post office if the service can continue, as my hon. Friend has argued, from somewhere else nearby.
	My hon. Friend rightly made the point that Tesco acquired the T and S group chain of stores at the end of 2002. Tesco took over the post office contracts for the individual sites and is reviewing how many of those post offices will be retained. The group includes stores trading under the One Stop and Dillons names, containing 318 post offices, as he said. I welcome Tesco's assurance that it will work closely with the Post Office when reviewing its stores with post offices.

Parmjit Dhanda: Is there not a point to be made about tying in consultations with urban area plans as well as post office reinvention?

Stephen Timms: My hon. Friend is quite right.
	Discussions have been held between Post Office Ltd. and Tesco. Tesco undertakes site-by-site review, and in a minority of locations where it chooses to establish a Tesco Express format, and where the site is consequently not large enough to continue to operate a post office branch, the company may wish to end the post office contract. To date, Tesco has confirmed that it intends to remove post offices from 37 stores that are to be converted to the Tesco Express format. It has also confirmed that it will retain around 260 post offices that operate from former T and S stores, including more than 200 in existing One Stop and Dillons stores and another 50 or so in those that are converted to Tesco Express stores.
	On that basis, I can confirm that the figure suggested by my hon. Friend—that about 100 post offices might go—is certainly too large. On the basis of the information that Tesco has given me, the number will be significantly less. It will not be more than 58, I think, and a decision has so far been made on only 37.

Parmjit Dhanda: Will my hon. Friend give way?

Stephen Timms: I must continue in order to make sure that I put on the record points that will be of wide interest in the House.
	Any decision by Tesco to terminate its contract and to remove a post office from one of its stores is, of course, a commercial matter for the company. But I know that the House would join me in urging Tesco to give careful consideration to the effect on its customers of such a decision.
	The history of the post office network can be traced back as far as 1635, and it has always been reliant on private business people to operate outlets. The vast majority, about 97 per cent., of the more than 16,000 post offices around the country are run by private business people, either by individual sub-postmasters or by chains such as Tesco. Typically, 10 per cent. of the offices in the network change hands from a resigning agent to a new agent each year.
	My hon. Friend pointed out that the last day of trading for the Longlevens post office was to be 8 May, but Tesco made it clear today that that planned date no longer applies. Like my hon. Friend, I welcome that announcement.
	To facilitate the relocation of post office services in Longlevens, Tesco has agreed with the Post Office that the contract can be transferred directly to a new partner, the costs of relocation being met by Tesco. Those arrangements should provide the best possible chance of relocating the post office locally, in line with the hopes expressed by my hon. Friend. I welcome Tesco's more flexible approach, and pay tribute to my hon. Friend for the energetic and, as we have heard, effective way in which he has pursued his constituent's interests.
	My hon. Friend mentioned that the local Co-op might be interested in taking on the service. These matters are of course commercially confidential, but I am certain that the company will ensure that my hon. Friend is notified of the resolution as soon as one has taken place.
	Tesco had given three months' notice of its intention. That is the time required by sub-postmasters' contracts, and it applies equally to either side. Where Tesco wants to remove a post office branch from one of its stores, it has committed itself, where possible, to giving twice that period of notice—six months rather than three. I hope that it will keep to that commitment in future cases, because the additional time will give the Post Office a better opportunity to review the need for an office and find alternative partners to continue to offer post office services where the need remains. Tesco's commitment to delaying the removal of the Longlevens office from its store and to work to ensure a smooth transfer of the business should be applauded.
	To its credit, Tesco has committed itself to helping the Post Office to maximise the prospects of a successful relocation of post offices that it can no longer accommodate in stores converted to the Tesco Express format where the Post Office needs to retain a post office in the area. It will work actively with the Post Office to find alternative individuals or businesses keen to operate the post office nearby.
	I hope that it is clear from what I have said that the proposed closure of Longlevens post office is not connected with the urban reinvention programme, but I shall say a little about that programme in the context of this debate. My hon. Friend has already seen a number of post office branches in his constituency close, as he has said. The aim of the programme is to address over-provision in many urban areas and to establish a network of offices that fits the level of business now available.

Parmjit Dhanda: Will my hon. Friend give way very briefly?

Stephen Timms: I do not think I can. There are a couple of points that I want to put on the record.
	I understand that Tesco has been made aware of the general time scale in which the Post Office is scheduled to produce its urban reinvention programme area plans, and where possible it will try to co-ordinate with the Post Office. I gather that in the case of my hon. Friend's constituency, the Post Office expects to do that in July or August. If, as in this instance, Tesco has reviewed a particular location, wants to end its contract and has advised the Post Office before the drawing up of the urban reinvention programme area plan, the Post Office can take a view, within its overall urban reinvention planning, on whether a post office branch is needed in that location. I think that that reflects my hon. Friend's hope that the two exercises can be brought together.
	Although the review of Gloucester is not due for some months, the Post Office has said that it aims to ensure continued service for the customers of Longlevens. As my hon. Friend said, the branch there was itself suggested as an alternative for customers of the Oxstalls branch, and the company is seeking an alternative partner in the vicinity. In other areas where Tesco decides to remove a post office from one of its stores and there is a need for the service to continue, the Post Office will work to replace the branch nearby. It has given an assurance that in such cases it will not view a decision by Tesco to remove a post office as any kind of blanket opportunity to close branches, over and above those being handled via the proper urban reinvention process.
	My hon. Friend talked of the possible threat to Barnwood post office. The Post Office is aware of the planning application for redevelopment of the Barnwood post office site, but I understand that no notice of termination of the contract or resignation of the sub-postmaster has been submitted. It will consider—
	The motion having been made after Ten o'clock, and the debate having continued for half an hour, Mr. Speaker adjourned the House without Question put, pursuant to the Standing Order.
	Adjourned at half-past Ten o'clock.